Comparative evaluation of erector spinae plane block and transversus abdominis plane block for postoperative analgesia in laparoscopic donor nephrectomy: A randomized controlled trial

ABSTRACT Introduction: This randomized parallel group trial was conducted to compare the postoperative analgesic efficacy of erector spinae (ES) plane block and transversus abdominis plane (TAP) plane block in laparoscopic donor nephrectomies. Methods: Sixty voluntary kidney donors received either TAP block (TAP group) or ES plane block (ES group) with 30 ml 0.5% ropivacaine at the end of surgery before tracheal extubation. Postoperatively, all patients received patient-controlled analgesia with intravenous fentanyl. Tramadol 100 mg was administered intravenously as a rescue analgesic. The primary outcome was 24 and 48 h of fentanyl consumption. Static and dynamic pain scores at 30 min, 2 nd , 6 th , 12 th , 24 th , and 48 th h, the requirement for rescue analgesia, incidence of postoperative vomiting, time to ambulation, flatus time, and donor satisfaction were secondary outcomes. Results: There was a significant reduction in fentanyl consumption in the ES group compared to the TAP group at 24 h (429.00 ± 103.06 μg vs. 537.33 ± 187.97 μg) ( P = 0.008) and 48 h (280.00 ± 104.79 μg vs. 367.33 ± 170.01 μg, P = 0.020). Static pain scores were significantly reduced in the ES group at all time points except at 48 th h. The ES group had lower dynamic pain scores at all time points; however, the difference was statistically significant only at 30 min ( P = 0.022), 6 h ( P = 0.027), and 48 h ( P = 0.048). Other secondary outcomes were similar in either group. Conclusion: ES plane block results in lower postoperative fentanyl consumption compared to TAP block in living donors undergoing laparoscopic nephrectomy.