Erector spinae plane block versus paravertebral block on postoperative quality of recovery in obese patients undergoing laparoscopic sleeve gastrectomy: a randomized controlled trial

Abstract

Purpose: To compare the impact of erector spinae plane block (ESPB) and paravertebral block (PVB) on the quality of postoperative recovery (QoR) of patients following laparoscopic sleeve gastrectomy (LSG).

Methods: A total of 110 patients who underwent elective LSG under general anesthesia were randomly assigned to receive either ultrasound-guided bilateral ESPB or PVB at T8 levels. Before anesthesia induction, 40 mL of 0.33% ropivacaine was administered. The primary outcome was the QoR-15 score at 24 hours postoperatively.

Results: At 24 hours postoperatively, the QoR-15 score was comparable between the ESPB and PVB groups (131 (112-140) vs. 124 (111-142.5), P = 0.525). Consistently, there was no significant difference in QoR-15 scores at 48 hours postoperatively, numerical rating scale (NRS) pain scores at any postoperative time points, time to first ambulation, time to first anal exhaust, postoperative cumulative oxycodone consumption, and incidence of postoperative nausea and vomiting (PONV) between the two groups (all P > 0.05). No nerve block-related complications were observed in either group.

Conclusion: In patients undergoing LSG, preoperative bilateral ultrasound-guided ESPB yields comparable postoperative recovery to preoperative bilateral ultrasound-guided PVB.

Keywords: Erector spinae plane block; Laparoscopic sleeve gastrectomy; Paravertebral block; Quality of recovery.

Figure 1. CONSORT diagram of study.

Figure 2. Distribution of QoR-15 scores at preoperative, 24-hour postoperative, and 48-hour postoperative time points in ESPB and PVB groups.

Violin plots depict probability density estimates using kernel density estimation. Median values are indicated by black dotted lines, and interquartile ranges by black solid lines. Group ESPB = Group erector spinae plane block, Group PVB = Group paravertebral block, Pre = Preoperative, PO24 h = Postoperative 24 h, PO48 h = Postoperative 48 h.