In Major Abdominal Surgeries, For Postoperative Analgesia, Should ESP Block or TAB Block Be Used?

Yoksa Tab Blok mu Kullanılmalıdır?Background: Postoperative pain management is a fundamental component of perioperative care.In major abdominal surgery, the transversus abdominis plane (TAP) block and the erector spinae plane (ESP) block are increasingly used as components of multimodal analgesia.This study aimed to compare the postoperative analgesic efficacy of ESP block and TAP block in patients undergoing major open abdominal surgery.Materials and Methods: Demographic characteristics, postoperative pain scores, analgesic consumption, postoperative nausea and vomiting (PONV), time to first analgesic request, mobilization time, time to oral intake, discharge time, adverse events, and patient satisfaction were retrospectively recorded for patients who underwent major abdominal surgery and received either an ESP or a TAP block.Results: The ESP group had lower unadjusted maximum VAS scores at rest VAS scores during the first 24 postoperative hours and lower maximum VAS scores during movement than the TAP group.However, because preoperative baseline pain numerical rating scale differed significantly between groups, a baseline-adjusted (rank ANCOVA) analysis was performed; after adjustment, the resting VAS difference was no longer statistically significant, and the movement VAS difference was of borderline significance.A group-bytime interaction was significant for resting VAS but not for movement VAS.In the ESP group, tramadol requirements were lower; the time to first analgesic request was longer; mobilization and oral intake occurred earlier; antiemetic use was lower; and late PONV (6-24 h) was less frequent.Patient satisfaction and time to discharge did not differ significantly between groups.After Bonferroni correction for multiple time-point comparisons, only the resting VAS differences at 12 and 24 h remained statistically significant. Conclusion:In this retrospective cohort study, ESP block improved recovery after major open abdominal surgery compared with TAP block, as evidenced by longer time to first analgesic request, lower tramadol use, earlier mobilization, and less late PONV.After adjustment for baseline pain, the unadjusted advantage did not persist for resting pain and remained borderline for movement pain; only the resting pain trajectory differed significantly between groups over time.