Erector Spinae Plane Block Versus Transversus Abdominis Plane Block In Laparoscopic Hysterectomy

Abstract

Background: The objective was to determine whether an erector spinae plane (ESP) block could provide additional postoperative analgesic benefits compared with a transversus abdominis plane block. Methods: 78 patients were separated into two groups (n = 39 per group). Both groups received bilateral injections of 266 mg Exparel® (20 ml) and 60 ml of 0.125% bupivacaine. Patients undergoing a transversus abdominis plane block received these injections intraoperatively, while patients undergoing an ESP block received these preoperatively. Outcomes were measured based on scores in opioid usage; pain (visual analog scale) at rest and with movement; nausea; sedation and patient satisfaction. Results: There were no significant intergroup differences in any category (all scores had p > 0.05). Conclusion: No additional analgesic benefits were found using the ESP block procedure.

A Randomized Controlled Trial Comparing Erector Spinae Plane and Transversus Abdominis Plane Blocks for Postoperative Analgesia after Elective Caesarean Section

“…A study by Kamel et al 19 found lower morphine consumption in patients receiving ESP compared to TAP blocks after total abdominal hysterectomy, but there was no difference in postoperative nausea and vomiting. A study conducted by Warner et al 24 in patients presenting for laparoscopic hysterectomies, showed no significant difference in pain scores, opioid consumption, or patient satisfaction between ESP and TAP blocks.…”

“…A study by Kamel et al19 found lower morphine consumption in patients receiving ESP compared to TAP blocks after total abdominal hysterectomy, but there was no difference in postoperative nausea and vomiting. A study conducted by Warner et al24 in patients presenting for laparoscopic hysterectomies, showed no significant difference in pain scores, opioid consumption, or patient satisfaction between ESP and TAP blocks.A study by Hassanin et al25 on emergency laparotomies, showed lower cumulative fentanyl consumption in the ESP vs TAP group but the study did not assess differences in opioidrelated side effects or patient satisfaction. A meta-analysis by Liheng et al26 comparing ESP and TAP blocks for abdominal surgery found ESP blocks lowered opioid consumption and pain scores statistically but did not reach clinically significant targets.…”