Both the erector spinae plane block (ESPB) and transversus abdominis plane block (TAPB) have been employed for analgesia in abdominal surgeries. Nevertheless, current evidence comparing the analgesic efficacy of ESPB and TAPB in patients undergoing laparoscopic hysterectomy remains both limited and conflicting, and the non-inferiority of ESPB has not been rigorously established. The purpose of this study was to evaluate whether the analgesic effect of ESPB for postoperative analgesia in patients undergoing laparoscopic hysterectomy was non-inferior to that of TAPB. This prospective, randomized, non-inferiority trial enrolled 96 patients. Participants were randomly allocated into two groups (ESPB and TAPB). All patients received bilateral regional blocks. The ESPB group was administered 30 mL of 0.25% ropivacaine at the T9 level, whereas the TAPB group received an equivalent volume and concentration at the midaxillary line. The primary outcome was total opioid consumption during the first 24 h postoperatively. The secondary outcomes included numerical rating scale (NRS) scores at rest and during movement at predefined time points, cumulative opioid consumption at 48 h, time to first patient-controlled intravenous analgesia (PCIA) demand, Quality of Recovery-15 (QoR-15) scale scores, and the incidence of adverse events. Morphine consumption at 24 h postoperatively was significantly lower in the ESPB group than in the TAPB group (P = 0.009)(MD: -3.86 mg; 95% CI: -6.72 to -1.00). Pain scores were also lower in the ESPB group for resting pain at 12 h and for movement pain at both 12 and 24 h (P < 0.05). Additionally, the ESPB group demonstrated significantly lower cumulative morphine consumption at 48 h (P = 0.002) and prolonged time to first PCIA demand (9 h vs. 6 h; P < 0.001). No significant differences were observed in other secondary outcomes. Ultrasound-guided ESPB provided non-inferior postoperative analgesia compared to TAPB after laparoscopic hysterectomy, with potential advantages in reducing opioid consumption and alleviating early postoperative movement-related pain. The number of this clinical trial registry is ChiCTR2500101798, date of registration: 28/02/2025.
Chen et al. (Thu,) studied this question.