Effects of Preoperative and Postoperative Erector Spinae Plane (ESP) Block on Postoperative Analgesia Score, Hemodynamic Response, and Patient Satisfaction in Patients Undergoing Laparoscopic Cholecystectomy Surgery

Objective: The aim of this study was to investigate the analgesic efficacy during the postoperative period following the preoperative and postoperative application of the Erector Spina Plan (ESP) block in patients undergoing Laparoscopic Cholecystectomy (LC) surgery. Materials and Methods: Our study was conducted after obtaining approval from the Clinical Research Ethics Committee of Harran University Hospital on 18.09.2023, decision number HRÜ/2023.17.13. Written and verbal consent was obtained from the patients after detailed information was provided, and the study was conducted in accordance with the Helsinki Declaration. A total of 80 patients were included in the study. It was designed as a prospective, randomized, and single-blind study. Patients were divided into two groups. In Group 1, 40 patients received a preoperative bilateral thoracic esp block at the T6-8 vertebra level. In Group 2, 40 patients received ESP block at the level of bilateral thoracic T6-8 vertebrae before awakening from anesthesia after the end of surgery. Pain scores (numeric rating scale, NRS), heart rate (HR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), postoperative analgesic consumption, and patient satisfaction scores were recorded for 24 hours postoperatively. Results: The average age of the patients examined in the study was 46.7 (18-65). 72% (n=57) were female. 67.5% of the patients (n=54) had an additional disease. 28% of the included patients had an American Society of Anesthesiologists (ASA) I score, while 72% had an ASA II score. 27.5% (n=22) were smokers. There was no difference in NRS scores measured at postoperative hours 0, 2, 4, 6, 12, and 24 between the groups (p>0.05). No difference was observed in the need for additional postoperative analgesics (p>0.05). When postoperative patient satisfaction scores were examined, it was concluded that there was no significant difference between the groups (p>0.05). Conclusion: In patients undergoing laparoscopic cholecystectomy, no significant difference was found in terms of postoperative analgesic efficacy, pain scores, additional analgesic requirement and patient satisfaction between preoperative and postoperative ESP block applications. We believe that ESPB application should be performed in the preoperative period to avoid complications related to lateral decubitus position in the postoperative period and to provide a more comfortable procedure for the patient. Keywords: Pain, Regional Anesthesia, Fascial plane blocks, Erector Spinae Plane Block (ESP), Laparoscopic cholecystectomy.