COMPARISON OF ERACTOR SPINAE PLANE BLOCK WITH OBLIQUE SUBCOSTAL TRANSVERSUS ABDOMINIS PLANE BLOCK IN TERMS OF PAIN AFTER LAPAROSCOPIC CHOLECYSTECTOMY

Abstract

Background:
Laparoscopic cholecystectomy (LC) is one of the most commonly performed minimally invasive abdominal surgeries, yet patients frequently experience moderate to severe postoperative pain due to visceral, somatic, and referred components. Optimizing analgesia is essential for early recovery and improved postoperative outcomes. Regional anesthesia techniques such as the oblique subcostal transversus abdominis plane (OS-TAP) block and the more recently introduced erector spinae plane block (ESPB) have emerged as valuable components of multimodal analgesia, but comparative evidence in LC remains limited.

Objective:
To compare the postoperative analgesic efficacy of ESPB versus OS-TAP block in patients undergoing LC.

Methods:
This randomized controlled trial was conducted at Hayatabad Medical Complex, Peshawar, from December 2021 to June 2022. A total of 138 adult patients undergoing LC for chronic cholecystitis were enrolled and randomized into two equal groups to receive either ESPB or OS-TAP block preoperatively. Pain was assessed at 12 postoperative hours using the Visual Analogue Scale (VAS). Demographic and clinical variables, including age, gender, BMI, and ASA class, were documented. Independent t-tests and stratified analyses were used for statistical comparison; p < 0.05 was considered significant.

Results:
Of the 100 patients included in the final analysis, most were middle-aged adults, overweight, and classified as ASA II. ESPB demonstrated significantly lower postoperative pain scores compared to OS-TAP across most demographic subgroups. Stratified analysis showed consistent analgesic superiority of ESPB irrespective of age, BMI, or ASA class.

Conclusion:
ESPB provided more effective postoperative analgesia than OS-TAP block for patients undergoing LC. Its broader dermatomal coverage and visceral analgesic potential support its use as a preferred component of multimodal analgesia in minimally invasive biliary surgery. Further multicenter studies are warranted to confirm these findings.