A Comparison of Erector Spinae Plane Block and Oblique Subcostal Transversus Abdominis Plane (TAP) Block for Postoperative Analgesia in Laparoscopic Cholecystectomy: A Randomized Controlled Study

Abstract

Background: Effective postoperative pain control following laparoscopic cholecystectomy is essential for early recovery and improved patient satisfaction. Ultrasound-guided erector spinae plane block (ESPB) and oblique subcostal transversus abdominis plane block (OSTAPB) are commonly used regional analgesic techniques; however, comparative evidence regarding their efficacy remains limited.

Materials & Methods: This prospective randomized comparative study was conducted among 60 patients undergoing elective laparoscopic cholecystectomy under general anaesthesia. Patients were randomly allocated into two groups: Group E received ultrasound-guided ESPB (n=30) and Group O received ultrasound-guided OSTAPB (n=30). The primary outcome was time to first rescue analgesia. Secondary outcomes included static and dynamic Visual Analogue Scale scores and total tramadol consumption during the first 24 postoperative hours.

Results: The mean time to first rescue analgesia was significantly longer in the ESPB group compared to the OSTAPB group (9.58 ± 1.2 vs 8.09 ± 1.0 hours; p<0.001). Static VAS scores were significantly lower in the ESPB group from 1 hour onwards, while dynamic VAS scores were significantly lower from 30 minutes onwards up to 24 hours postoperatively (p<0.001). Total postoperative tramadol consumption was significantly reduced in the ESPB group compared to the OSTAPB group (6.67 ± 17.2 mg vs 61.67 ± 44.8 mg; p<0.001).

Conclusion: Ultrasound-guided ESPB provided superior postoperative analgesia with prolonged analgesic duration, lower pain scores, and reduced opioid consumption compared to OSTAPB in patients undergoing laparoscopic cholecystectomy.