Ultrasound-guided bilateral Erector spinae plane block versus intraperitoneal instillation and port site infiltration with local anesthetic for postoperative analgesia in obese patients undergoing laparoscopic cholecystectomy | ||
| Minia Journal of Medical Research | ||
| Articles in Press, Accepted Manuscript, Available Online from 07 November 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/mjmr.2025.438694.2124 | ||
| Authors | ||
| Karim Naser Hasan1; amany Khairy2; Rehab Raafat* 3 | ||
| 1Faculty of Medicine, Minia University, El-Minya, Egypt | ||
| 2Department of Anesthesia, El-Minia Faculty of Medicine | ||
| 3Anesthesiology and intensive care department, Faculty of medicine, Minia University. | ||
| Abstract | ||
| • Background: Pain after laparoscopic cholecystectomy (LC) is common and may be moderate to severe in the early postoperative phase, especially in obese patients. As obese patients face an increased risk for opioid-related adverse events, regional anesthetic techniques are utilized, as part of multimodal analgesia, to avoid use of opioids. • Aim of work: This study compared the analgesic efficacy of erector spinae plane block (ESP) and intraperitoneal (IP) instillation with port-site infiltration with bupivacaine in obese patients undergoing LC. • Patients and Methods: This study involved 96 adult obese patients (BMI > 30 kg/m²), scheduled for elective LC. Patients were randomly allocated to 3 groups: Group B: received bilateral ESP block postoperatively, Group I: recieved IP instillation and port-site infiltration with bupivacaine at end of surgery, and Group C: had conventional postoperative analgesia. Time to first rescue analgesia, Numerical rating scale • Results: ESP block showed longer time to first rescue analgesia, lower pain scores up to 12 hr postoperatively, and less consumption of opioid over 24 hr, compared to I and C groups. However, Group I had longer analgesia, lower pain scores up to 6 hr. and less opioid consumed, compared with C group. Both intervention groups (B and I) showed reduced PONV and shoulder pain, earlier ambulation and greater patient satisfaction than control group (p < 0.001). • Conclusion: Ultrasound-guided ESP block offers better quality of postoperative analgesia compared with IP instillation and port-site infiltration with bupivacaine after LC in obese patients. However, instillation and port-site infiltration | ||
| Keywords | ||
| Erector spinae plane block; Intraperitoneal instillation; Port-site infiltration | ||
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