Ultrasound‐Guided Erector Spinae Plane Block Versus Transversus Abdominis Plane Block for Postoperative Analgesia in Adult Patients Undergoing Laparoscopic Appendectomy

Background Effective postoperative analgesia is essential after laparoscopic appendectomy. This randomized, double‐blind controlled study compared the analgesic efficacy of ultrasound‐guided erector spinae plane block (ESP) and the transversus abdominis plane block (TAP). Methods This randomized, double‐blind controlled study included 72 adult patients undergoing laparoscopic appendectomy. The primary outcome was the 24 h postoperative Numerical Rating Scale (NRS) pain score. Secondary outcomes included time to first rescue analgesia, total 24 h pethidine consumption, intraoperative fentanyl requirements, and adverse events. Patients were randomized to receive either an ultrasound‐guided erector spinae plane block or a transversus abdominis plane block. Results The erector spinae plane block group demonstrated significantly lower postoperative pain scores (mean difference −0.8 to −1.4), longer time to first rescue analgesia (mean difference 1.6 hours; 95% CI: 1.2−2.0), and reduced 24‐hour pethidine consumption (mean difference −43.1 mg; 95% CI: −54.0 to −32.1). No major complications occurred. Conclusion The erector spinae plane block provides superior postoperative analgesia after laparoscopic appendectomy and supports its inclusion in multimodal analgesic pathways. Trial Registration: ClinicalTrials.gov: NCT06220513