The effect of plan blocks (ESP & OSTAP) applied under ultrasonography on perioperative analgesia in laparoscopic hysterectomies

Introduction and Objective: Pain management after laparoscopic hysterectomy is extremely important. Plane blocks are an important component of multimodal analgesia. In the present study, it was aimed to evaluate the effect of USG-guided ESP and OSTAP blocks on perioperative pain and opioid consumption in patients undergoing total laparoscopic hysterectomy under general anaesthesia. Materials and Methods: After approval by the Clinical Research Ethics Committee of Balıkesir University Faculty of Medicine (2022/126) and the Turkish Medicines and Medical Devices Agency (22-AKD-87), 117 patients aged 18-65 years, BMI ≤ 30 kg/m2, ASA I-II volunteers, scheduled for elective laparoscopic hysterectomy were included in the study. The patients were divided into 2 groups as ESP (Group I) and OSTAP (Group II) by preoperative randomisation. After general anaesthesia was induced, the patients were intubated orotracheally. In Group I, ESP block was performed in the lateral decubitus position under USG guidance, while in Group II, OSTAP block was performed in the supine position under USG guidance. Operative incision was performed 15 minutes after the block application. Assessment of pain intensity was performed by NRS at rest and on movement. The patient's PCA demand and successful bolus doses and the amount of morphine given at 0, 2, 4, 6, 12 and 24 hours postoperatively were recorded. Results: There was no statistical significance between Group I and Group II in terms of intraoperative remifentanil consumption and postoperative 24 h total morphine consumption. The number of analgesics requested and administered through the PCA at 0, 2, 4, 6, 12, 24 hours postoperatively, NRS at rest and on movement, nausea and vomiting score and OAAS/S did not show statistical significance between the groups. Conclusion: In patients undergoing laparoscopic hysterectomy, ESP and OSTAP blocks can be used as an important component of perioperative analgesia. We think that multi-centered studies with different patient groups and practitioners should be carried out with wider participation. Key words: Erector spina plane block, oblique subcostal transversus abdominus plane block, laparoscopic hysterectomy, analgesia, opioid.