Ultrasound-guided bilateral Erector Spinae Plane Block (ESPB) for postoperative analgesia in laparoscopic cholecystectomy: a randomized controlled trial

Background: Laparoscopic cholecystectomy (LC) is a commonly performed procedure with significant postoperative pain, leading to potential complications such as delayed recovery and opioid-related side effects. Regional anesthesia, particularly the Erector Spinae Plane Block (ESPB), has shown promise in improving postoperative analgesia. This study investigates the effectiveness of ultrasound-guided (USG) bilateral ESPB for pain management in LC, compared to standard multimodal analgesia. Materials and methods: This double-blind randomized controlled trial included 48 patients undergoing LC at a tertiary hospital between June 2022 and June 2023. Patients were randomly assigned to two groups: 24 received USG bilateral ESPB with 0.25% ropivacaine, and 24 received standard multimodal analgesia. Statistical analysis was conducted using t-tests, ANOVA, and chi-squared tests, with a P-value of less than 0.05 considered significant. Results: The ESPB group experienced significantly prolonged analgesia, with a mean time to rescue analgesia of 11.2 hours compared to 0.5 hours in the control group (P < 0.001). Pain scores were consistently lower in the ESPB group for the first 6 hours postoperatively. Additionally, total tramadol consumption in the ESPB group was significantly reduced (172.92 mg vs. 245.83 mg, P < 0.001). Patient satisfaction was higher in the ESPB group. Conclusion: USG bilateral ESPB significantly enhances postoperative pain management in LC, reducing both pain intensity and opioid consumption. It represents a safer alternative to opioid-based analgesia, improving recovery and patient outcomes.