Investigation of the Effect of Ultrasonography Guided Bilateral Erector Spina Plane Block on Postoperative Opioid Consumption and Pain Scores in Patients with Hepatectomy Operation: A Prospective, Randomized, Controlled Study

Abstract Background: Effective and safe postoperative analgesia in hepatectomy surgery is still debated. Erector spina plane block can potentially have a both somatic and visceral analgesic effect and may be an important part of multimodal analgesia application in hepatectomy surgery. Objectives: To compare the effect of ultrasound-guided bilateral erector spinae plane block with intravenous patient-controlled analgesia in hepatectomy surgery. Design and Settings: The study was designed as randomized, prospective, single-blinded in a tertiary university hospital. Methods: Fifty patients, aged 18 to 65 years with ASA scores of I-III scheduled for elective hepatectomy surgery were included in the study. Patients were randomized into two groups as ESP group and Control group. Ultrasound guided ESP block at T8 vertebral level was performed preoperatively by administering 20 ml 0.375% bupivacaine+4 mg dexamethasone bilateral and intravenous patient-controlled analgesia to the patients in ESP group. Patients in Control group used only intravenous patient-controlled analgesia. Numeric Rating Scale (NRS) scores at rest and coughing were recorded at 10th min., at 1, 6, 12 and 24 h. postoperatively. Intraoperative and postoperative analgesic requirements, rescue analgesic requirements, postoperative nausea and vomiting were also recorded. Results: Fifty patients were included in the final analyses. Intraoperative and postoperative opioid consumption and rescue analgesic requirement were y lower in the ESP group. Rest and dynamic NRS scores were lower in the ESP group in all time points . There was no significant difference between the two groups in terms of the presence of dynamic pain after the postoperative 1st hour. While all patients in the Control group had nausea and vomiting, 24% of the patients in the ESP group did not have nausea and vomiting. Conclusion: This study has showed that ESP block can be used as a part of multimodal analgesia by reducing opioid consumption and postoperative nausea and vomiting in hepatectomy surgery.