Comparison of Analgesic Efficacy of Ultrasound Guided Bilateral Erector Spinae Block with Intravenous Analgesia in Total Laparoscopic Hysterectomy – A Prospective Randomized Controlled Trial

Abstract

Pain is common after total laparoscopic hysterectomy and some form of analgesia is required , either regional or intravenous analgesia . We randomly allocated 92 cases of total laparoscopic hysterectomy into two groups, where the  control group received intravenous paracetamol with rescue tramadol, while the erector spinae plane block group received bilateral T10 ultrasound guided erector spinae block with 20 mL of 0.25% ropivacaine on each side in addition to the same intravenous analgesia. Rescue tramadol requirement and postoperative Numerical Rating Scale (NRS) and Bruggeman Comfort Scale (BCS) scores were assessed for 24 hours. Postoperative NRS scores were significantly lower and BCS scores were higher in the ESPB group at 0, 2 , 4 , 6 , 8 , 10 , 12 , 24 hrs.  Ultrasound-guided bilateral erector spinae plane block provided superior postoperative analgesia, reduced rescue opioid requirement, and improved patient comfort following total laparoscopic hysterectomy.