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Randomized Controlled Trial
. 2025 May 26;25(1):270.
doi: 10.1186/s12871-025-03138-3.

Comparison of analgesic efficacy of erector spinae plane block at different levels in laparoscopic cholecystectomies: a randomized controlled trial

Serpil Şehirlioğlu  1 , Ümran Yaman  2 , Ayfer Kaya Gök  2 , Ülkü Aygen Türkmen  2 , Döndü Genç Moralar  2 , Muhammed Özdemir  3
Affiliations
Randomized Controlled Trial

Comparison of analgesic efficacy of erector spinae plane block at different levels in laparoscopic cholecystectomies: a randomized controlled trial

Serpil Şehirlioğlu et al. BMC Anesthesiol. .

Abstract

Background: Erector Spinae Plane Block (ESPB) is employed as a component of multimodal analgesia in laparoscopic cholecystectomy (LC) procedures. The objective of this study is to assess the impact of ESPB performed at different levels during LC operations on postoperative pain scores and opioid consumption.

Methods: A total of 103 patients undergoing LC were divided into three groups: Group Th7 (ESPB administered at the 7th thoracic vertebra level), Group Th9 (ESPB administered at the 9th thoracic vertebra level), and the control group. Patients were evaluated at 30 min, 1, 4, 8, 12, and 24 h postoperatively. Morphine consumption within the first 24 h postoperatively, resting and dynamic Numeric Rating Scale (NRS) scores, and complication rates were assessed.

Results: When comparing morphine consumption among the groups, it was observed that patients who received ESP blocks had significantly lower morphine consumption at 1, 4, 8, 12, and 24 h compared to the control group. However, no significant difference was found between Group Th7 and Group Th9. In Group Th7 and Group Th9, the resting NRS scores at 30 min, 1, 4, and 24 h, as well as all dynamic NRS scores except at the 8th hour, were significantly lower compared to the control group. However, there was no significant difference between Group Th7 and Group Th9.

Conclusion: In LC surgeries, ESPB administered at the Th7 and Th9 levels exhibited similar analgesic efficacy. ESPB applied at the Th7 and Th9 levels can be utilized as part of multimodal analgesia.

Keywords: Enhanced recovery after surgery; Erector spinae plane block; Laparoscopic cholecystectomy; Multimodal analgesia; Opioid free analgesia; Postoperative analgesia.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: It received approval from the Gaziosmanpaşa Training and Research Hospital Clinical Research Ethics Committee on 25/12/2019 (decision no: 2019/168) and was registered on ClinicalTrials.gov (Registration no: NCT04316416). The study was conducted in the general surgery operating room, following the principles of the Helsinki Declaration, between 15/02/2020 and 02/06/2021. Written and verbal informed consent was obtained from all patients. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
CONSORT flow diagram of the study
Fig. 2
Fig. 2
Kaplan-Meier analysis of time to first analgesic request among the groups. Group Th7 (ESP block at Th7), Group Th9 ( ESP block at Th9) and the Control group
Fig. 3
Fig. 3
Change in rest and dynamic NRS scores over time among the groups
See this image and copyright information in PMC

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