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Randomized trial demonstrates superior pain relief and reduced opioid needs with erector spinae plane block in laparoscopic cholecystectomy, highlighting its utility for postoperative analgesia.
Background: Postoperative pain after laparoscopic cholecystectomy has both somatic and visceral components. This studycompared ultrasound-guided erector spinae plane block with port-site infiltration for perioperative analgesia. Materials andMethods: Seventy ASA I–II patients undergoing elective laparoscopic cholecystectomy were randomized into two groups of35 patients. Group A received bilateral ultrasound-guided ESP block at T7 using 20 mL of 0.25% bupivacaine on each side.Group B received port-site infiltration with 20 mL of 0.25% bupivacaine. Postoperative NRS scores, intraoperative fentanylrequirement, time to first rescue analgesia, postoperative tramadol consumption and adverse effects were compared. Results:Postoperative NRS scores were significantly lower in the ESP block group at all observed time points (p<0.001). Meanintraoperative fentanyl requirement was 100.00 ± 38.35 μg in Group A and 150.14 ± 34.18 μg in Group B (p<0.001). Timeto first rescue analgesia was significantly longer with ESP block (6.23 ± 1.51 vs 1.00 ± 0.00 hours, p<0.001). Totalpostoperative tramadol consumption was lower in Group A (100.4 ± 14.5 vs 142.0 ± 14.3 mg, p<0.001). The table currentlyshows p=0.025, whereas the Results and thesis-based value being retained is p=0.029. Conclusion: Ultrasound-guidedbilateral ESP block provided better postoperative analgesia, prolonged time to rescue analgesia and reduced perioperativeopioid requirement compared with port-site infiltration in laparoscopic cholecystectomy.
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