Comparing Ultrasound-Guided Erector Spinae Plane Block vs Oblique Subcostal TAP Block Analgesia After Laparoscopic Cholecystectomy: A Randomized Clinical Study

Background: There has been growing interest in using nerve blocks, like the erector spinae plane (ESP) block as well as the oblique subcostal transversus abdominis plane (OSTAP) block, as part of pain control plans after surgery. While both techniques have shown benefits in various abdominal surgeries, their role in laparoscopic cholecystectomy is still being explored.
Aim: This study set out to compare how effective the ultrasound-guided ESP block and OSTAP block are in controlling pain after laparoscopic cholecystectomy, focusing on pain scores, how long before patients needed extra pain medicine, and the amount of morphine given.
Patients and Methods: Fifty adults who were scheduled for laparoscopic gallbladder removal at Helwan University Hospitals were randomly allocated to two groups. One group received the ESP block, while the other group got the OSTAP block, both using ultrasound guidance before surgery started. The main outcomes measured were pain ratings over the first day after surgery.
Results: Patients in the ESP group tended to report lower pain ratings at several time points after surgery. They also needed their first dose of morphine later and ended up using less total morphine over the first day compared to those in the OSTAP group. No major differences were found in side effects between the two studied groups.
Conclusion: Both blocks were helpful for pain control after laparoscopic cholecystectomy, but the ESP block gave longer and stronger pain relief, allowing patients to need less morphine overall.