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Updated: May 15, 2025

Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
Published on: January 31, 2025
Ultrasound-guided bilateral Erector Spinae Plane Block (ESPB) for postoperative analgesia in laparoscopic
Arun Kumar Mandal1, Bibek Shrestha2, Krishna Kumar Yadav3
1BP Koirala Institute of Health Sciences, Dharan, Nepal.
Background:
Laparoscopic cholecystectomy (LC) is a commonly performed procedure with significant postoperative pain, leading to potential complications such as delayed recovery and opioid-related side effects. Regional anesthesia, particularly the Erector Spinae Plane Block (ESPB), has shown promise in improving postoperative analgesia. This study investigates the effectiveness of ultrasound-guided (USG) bilateral ESPB for pain management in LC, compared to standard multimodal analgesia.
Materials And Methods:
This double-blind randomized controlled trial included 48 patients undergoing LC at a tertiary hospital between June 2022 and June 2023. Patients were randomly assigned to two groups: 24 received USG bilateral ESPB with 0.25% ropivacaine, and 24 received standard multimodal analgesia. Statistical analysis was conducted using t-tests, ANOVA, and chi-squared tests, with a P-value of less than 0.05 considered significant.
Results:
The ESPB group experienced significantly prolonged analgesia, with a mean time to rescue analgesia of 11.2 hours compared to 0.5 hours in the control group (P < 0.001). Pain scores were consistently lower in the ESPB group for the first 6 hours postoperatively. Additionally, total tramadol consumption in the ESPB group was significantly reduced (172.92 mg vs. 245.83 mg, P < 0.001). Patient satisfaction was higher in the ESPB group.
Conclusion:
USG bilateral ESPB significantly enhances postoperative pain management in LC, reducing both pain intensity and opioid consumption. It represents a safer alternative to opioid-based analgesia, improving recovery and patient outcomes.
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