July 30, 2025BMC AnesthesiologyOpen Access

A comparison of ultrasound-guided erector spinae plane block and epidural anesthesia for postoperative recovery in elderly individuals following laparoscopic gastrectomy: a randomized controlled trial

Q: What is the clinical evidence from this study?

Study design: RCT. Population: Gastric cancer (n=102). Intervention: Erector spinae plane block (EspB) vs. Epidural anesthesia (EDA) or general anesthesia alone. Primary outcome: Quality-of-recovery (QoR-15) score at 24 hours postoperatively (p=<0.001).

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Key result

Erector spinae plane block significantly improved quality of recovery at 24 hours postoperatively compared to general anesthesia alone, providing comparable analgesia to epidural anesthesia but with fewer side effects.

Why the study?

The study aimed to evaluate the analgesic efficacy and postoperative recovery outcomes of erector spinae plane block versus epidural anesthesia in elderly patients undergoing laparoscopic gastrectomy to identify precise multimodal analgesia.

Does ultrasound-guided erector spinae plane block improve postoperative quality of recovery compared to epidural anesthesia or general anesthesia alone in elderly patients undergoing laparoscopic gastrectomy?

Population

102 elderly patients (above 65 years-of-age) undergoing elective laparoscopic gastrectomy

Comparison

Bilateral EspB plus GA vs EDA plus GA vs GA alone

Design

Randomized controlled trial

Follow-up

7 days postoperatively

Authors

JSJie SongBinzhou Medical University STSong Tong YLYun LiGuangdong Provincial People's Hospital

Discussion

Member takes

Implication

EspB matches EDA for recovery and analgesia but with less PONV; extends RCT support for its use in multimodal regimens for elderly gastrectomy patients.

Study Design

Type

RCT (n=102)

Blinding

Double-blind

Randomization

Computer-generated random numbers

Multicenter

Structured PICO

Population

102 elderly adults (aged >65 years) with gastric cancer undergoing elective laparoscopic radical gastrectomy, randomized to receive erector spinae plane block, epidural anesthesia, or general anesthesia alone.

Intervention

Preoperative bilateral ultrasound-guided erector spinae plane block (EspB) with 30 ml of 0.375% ropivacaine, combined with general anesthesia and a sham epidural catheter.

Comparator

Epidural anesthesia (EDA) with 0.375% ropivacaine plus general anesthesia, or general anesthesia alone with a sham epidural catheter and subcutaneous lidocaine infiltration.

Outcome

Quality-of-recovery (QoR) evaluated by the QoR-15 questionnaire at T1 (24 hours postoperatively).patient reported

Main Result

Absolute Event Rate: 112.09% vs 102.74%

p-value: p=<0.001

Erector spinae plane block provides comparable postoperative recovery and analgesia to epidural anesthesia but with fewer side effects such as hypotension, nausea, and vomiting in elderly patients undergoing laparoscopic gastrectomy.

Limitations

Sample size may be insufficient to capture subtle differences in analgesic efficacy
Optimal ropivacaine dose for EspB and EDA remains unclear
Long-term follow-up is not feasible
Volume of local anesthetic used in the EspB group may influence the spread and efficacy of the block
Findings may not be indicative for younger individuals

Cite This Study

Song et al. (2025) conducted an RCT in Gastric cancer (n=102). Erector spinae plane block (EspB) vs. Epidural anesthesia (EDA) or general anesthesia alone was evaluated on Quality-of-recovery (QoR-15) score at 24 hours postoperatively (p=<0.001). Erector spinae plane block significantly improved quality of recovery at 24 hours postoperatively compared to general anesthesia alone, providing comparable analgesia to epidural anesthesia but with fewer side effects.

synapsesocial.com/papers/6a9923c2ee2e02d2bfe10c97 https://doi.org/10.1186/s12871-025-03265-x

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July 30, 2025BMC AnesthesiologyOpen Access

A comparison of ultrasound-guided erector spinae plane block and epidural anesthesia for postoperative recovery in elderly individuals following laparoscopic gastrectomy: a randomized controlled trial

View Full Paper

Ask AI

Bookmark

Key result

Why the study?

Population

102 elderly patients (above 65 years-of-age) undergoing elective laparoscopic gastrectomy

Comparison

Bilateral EspB plus GA vs EDA plus GA vs GA alone

Design

Randomized controlled trial

Follow-up

7 days postoperatively

Authors

JSJie SongBinzhou Medical University STSong Tong YLYun LiGuangdong Provincial People's Hospital

Discussion

Member takes

Implication

EspB matches EDA for recovery and analgesia but with less PONV; extends RCT support for its use in multimodal regimens for elderly gastrectomy patients.

Study Design

Type

RCT (n=102)

Blinding

Double-blind

Randomization

Computer-generated random numbers

Multicenter

Structured PICO

Population

Intervention

Preoperative bilateral ultrasound-guided erector spinae plane block (EspB) with 30 ml of 0.375% ropivacaine, combined with general anesthesia and a sham epidural catheter.

Comparator

Epidural anesthesia (EDA) with 0.375% ropivacaine plus general anesthesia, or general anesthesia alone with a sham epidural catheter and subcutaneous lidocaine infiltration.

Outcome

Quality-of-recovery (QoR) evaluated by the QoR-15 questionnaire at T1 (24 hours postoperatively).patient reported

Main Result

Absolute Event Rate: 112.09% vs 102.74%

p-value: p=<0.001

Limitations

Sample size may be insufficient to capture subtle differences in analgesic efficacy
Optimal ropivacaine dose for EspB and EDA remains unclear
Long-term follow-up is not feasible
Volume of local anesthetic used in the EspB group may influence the spread and efficacy of the block
Findings may not be indicative for younger individuals

Cite This Study

synapsesocial.com/papers/6a9923c2ee2e02d2bfe10c97 https://doi.org/10.1186/s12871-025-03265-x

Also Consider

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