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

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: A total of 60 patients aged 18 to 65 years with a body mass index (BMI) of ≥ 40 kg/m were randomly allocated into two groups. Patients received either bilateral erector spinae plane block using 20 mL bupivacaine 0.25% at the level of the T7 transverse process or bilateral sham block using 20 mL normal saline on each side. Visual analog scale, intraoperative fentanyl consumption, the cumulative 24-hour postoperative morphine consumption, and postoperative pulmonary functions were recorded.

Results: Visual analog scale for the first eight postoperative hours were significantly lower in the erector spinae plane block group than the control group. The median (interquartile range [IQR]) intraoperative fentanyl consumption was higher in the control group (159.5 [112.0 to 177.8] μg) than in the erector spinae plane block group (0.0 [0.0 to 74.5] μg) (P < 0.001). The median (IQR) cumulative 24-hour postoperative morphine consumption was lower in the erector spinae plane block group (8.0 [7.0 to 9.0] mg) than in the control group (21.0 [17.0 to 26.25] mg) (P < 0.001, 95% CI [11.00, 15.00]). Postoperative pulmonary functions were significantly impaired in both groups compared with 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 with the control group.