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Efficacy of Ultrasound Guided Bilateral Erector Spinae Block for Postoperative Analgesia in Patients Undergoing Laparoscopic Cholecystectomy under General Anaesthesia – A Randomised Control Study


Affiliations
1 Department of Anaesthesiology and Critical Care, Bangalore Medical College and Research Institute, Bangalore – 560002, Karnataka, India
 

Background: The Ultrasound guided Erector spinae plane block is a novel paraspinal plane block, first described in 2016 for thoracic analgesia at T5 level. Currently there are only a few case reports/studies on ultrasound guided erector spinae block with inconsistent results, hence this study was undertaken to assess the post-operative analgesic efficacy in patients undergoing laparoscopic cholecystectomy under general anaesthesia. Material and Methods: Thirty patients aged between 20 to 60 yrs of American Society of Anaesthesiologists (ASA) grade 1 and 2, undergoing laparoscopic cholecystectomy under general anaesthesia were randomly allocated into two groups of 15 each. Group C–Laparoscopic cholecystectomy under general anaesthesia without erector spinae block and Group E–Laparoscopic cholecystectomy under general anaesthesia with erector spinae block at T7 level using 20ml of 0.25% plain bupivacaine bilaterally. Intraoperative vitals, isoflurane consumption, duration of postoperative analgesia, postoperative paracetamol requirement and visual analogue scores were noted. Results: The demographic parameters were comparable. Pain scores were lower in group E. Post-operative duration of analgesia was prolonged in group E (group C-100.00 ± 34.49 mins, group E-513.00 ± 121.30 mins with p value < 0.001). 24hrs paracetamol requirement (group C-3930 ± 260 mg, group E-1733 ± 960 mg with p value < 0.001) and isoflurane consumption (at 30mins: Group C-6.87 ± 1.41 ml, group E-4.40 ± 1.18 ml with p value < 0.001, at 60mins: group C-13.93 ± 4.64, group E-10.87 ± 3.56 with p value 0.052) were lower in group E. Conclusion: Ultrasound guided bilateral erector spinae plane block provides longer duration of postoperative analgesia with reduced requirement of rescue analgesia in patients undergoing laparoscopic cholecystectomy.

Keywords

Bupivacaine, Erector Spinae Block, Postoperative Analgesia, Ultrasound.
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  • Efficacy of Ultrasound Guided Bilateral Erector Spinae Block for Postoperative Analgesia in Patients Undergoing Laparoscopic Cholecystectomy under General Anaesthesia – A Randomised Control Study

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Authors

Ranjitha Gangadharaiah
Department of Anaesthesiology and Critical Care, Bangalore Medical College and Research Institute, Bangalore – 560002, Karnataka, India
D. Devika Rani
Department of Anaesthesiology and Critical Care, Bangalore Medical College and Research Institute, Bangalore – 560002, Karnataka, India
N. Venkatesh
Department of Anaesthesiology and Critical Care, Bangalore Medical College and Research Institute, Bangalore – 560002, Karnataka, India
S. Nithish
Department of Anaesthesiology and Critical Care, Bangalore Medical College and Research Institute, Bangalore – 560002, Karnataka, India
S. S. Nethra
Department of Anaesthesiology and Critical Care, Bangalore Medical College and Research Institute, Bangalore – 560002, Karnataka, India

Abstract


Background: The Ultrasound guided Erector spinae plane block is a novel paraspinal plane block, first described in 2016 for thoracic analgesia at T5 level. Currently there are only a few case reports/studies on ultrasound guided erector spinae block with inconsistent results, hence this study was undertaken to assess the post-operative analgesic efficacy in patients undergoing laparoscopic cholecystectomy under general anaesthesia. Material and Methods: Thirty patients aged between 20 to 60 yrs of American Society of Anaesthesiologists (ASA) grade 1 and 2, undergoing laparoscopic cholecystectomy under general anaesthesia were randomly allocated into two groups of 15 each. Group C–Laparoscopic cholecystectomy under general anaesthesia without erector spinae block and Group E–Laparoscopic cholecystectomy under general anaesthesia with erector spinae block at T7 level using 20ml of 0.25% plain bupivacaine bilaterally. Intraoperative vitals, isoflurane consumption, duration of postoperative analgesia, postoperative paracetamol requirement and visual analogue scores were noted. Results: The demographic parameters were comparable. Pain scores were lower in group E. Post-operative duration of analgesia was prolonged in group E (group C-100.00 ± 34.49 mins, group E-513.00 ± 121.30 mins with p value < 0.001). 24hrs paracetamol requirement (group C-3930 ± 260 mg, group E-1733 ± 960 mg with p value < 0.001) and isoflurane consumption (at 30mins: Group C-6.87 ± 1.41 ml, group E-4.40 ± 1.18 ml with p value < 0.001, at 60mins: group C-13.93 ± 4.64, group E-10.87 ± 3.56 with p value 0.052) were lower in group E. Conclusion: Ultrasound guided bilateral erector spinae plane block provides longer duration of postoperative analgesia with reduced requirement of rescue analgesia in patients undergoing laparoscopic cholecystectomy.

Keywords


Bupivacaine, Erector Spinae Block, Postoperative Analgesia, Ultrasound.

References