Efficiency of erector spinae plane block with ultrasonography in laparoscopic cholecystectomy

Aims: The aim of our study is to evaluate the effects of ultrasound – guided erector spinae plane block (ESPB) on intraoperative opioid requirement, postoperative analgesic consumption and patient satisfaction in laparoscopic cholecystectomy (LC) procedures. Methods: Ninety patients aged 18–65 years with American Society of Anesthesiologists (ASA) risk classification I–III who underwent elective laparoscopic cholecystectomy between December 2018 and December 2020 were retrospectively analyzed. Patients were divided into three groups: control (no block), preoperative ultrasound-guided ESPB, and postoperative ESPB performed just before extubation. Intraoperative opioid consumption, postoperative Visual Analog Scale (VAS) scores, additional analgesic requirements, and patient satisfaction were evaluated. Results: There were no significant differences among the groups regarding age, sex, height, or ASA physical status (p > 0,05). However, significant differences were observed in mean body weight and body mass index (BMI) values (p = 0.006 and p = 0.007, respectively). Pairwise comparisons revealed no significant differences in body weight or BMI between the preoperative and postoperative ESPB groups (p = 0.787 and p = 0.882); however, both block groups had significantly higher values compared with the control group (p < 0.05). VAS scores, postoperative analgesic requirements, and patient satisfaction differed significantly among the groups at postoperative 0, 1, 2, 6, 12, and 24 hours, in favor of both ESPB groups (p < 0.001). Postoperative VAS scores at 0, 1, 2, and 6 hours were significantly lower in the preoperative ESPB group compared with the postoperative ESPB group (p < 0.001). Intraoperative opioid consumption and postoperative additional analgesic requirements were also significantly lower in the preoperative ESPB group than in the other two groups (p < 0.001). However, VAS scores and patient satisfaction at 12 and 24 hours were comparable between the two ESPB groups. In the control group, VAS scores at postoperative 0, 1, 2, 6, 12, and 24 hours were significantly higher (p < 0.001), resulting in a significantly greater need for additional analgesia. Conclusion: Preemptive ESPB reduces the need for intraoperative opioids and maximizes patient satisfaction with postoperative low VAS scores.