Ultrasound‐Guided Erector Spinae Plane Block in Patients Undergoing Laparoscopic Bariatric Surgery: A Prospective Randomized Controlled Trial

Abstract

Background Bariatric surgery is frequently complicated with considerable postoperative pain. We evaluated the impact of ultrasound‐guided erector spinae plane block on perioperative analgesia and pulmonary functions following laparoscopic bariatric surgery. Methods 60 patients aged 18‐ 65 years with a BMI of ≥40 were randomly allocated into two groups. Patients received either bilateral erector spinae plane block using 20 ml bupivacaine 0.25% at the level of T7 transverse process or bilateral sham block using 20 ml normal saline on each side. Visual Analog Scale, intraoperative fentanyl consumption, the cumulative 24 h postoperative morphine consumption and postoperative pulmonary functions were recorded. Results Visual Analog Scale for the 1st eight postoperative hours were significantly lower in the erector spinae plane block group than the control group. The median (IQR) intraoperative fentanyl consumption was higher in the control group (159.5 (112.0 – 177.8) μg) compared to erector spinae plane block group (0.0 (0.0 ‐ 74.5) μg) (P˂0.001). The median (IQR) cumulative 24 h postoperative morphine consumption was lower in the erector spinae plane block group [8.0 (7.0 – 9.0) mg] compared to the control group [21.0 (17.0–26.25) mg] (P ˂0.001, 95% CI (11.00, 15.00)). Postoperative pulmonary functions were significantly impaired in both groups compared to baseline values without significant difference between both groups. Conclusion Ultrasound‐guided erector spinae plane block provided satisfactory postoperative analgesia following laparoscopic bariatric surgery with decreased analgesic consumption without significant difference in postoperative pulmonary functions compared to control group.