Comparison of the effects of erector spinae plane block and modified thoracoabdominal plane block on postoperative analgesia in laparoscopic cholecystectomy surgery

Effective control of postoperative pain in laparoscopic cholecystectomy remains a clinically significant issue. This study aims to compare the efficacy of the M-TAPA and ESP blocks, both of which are employed within the framework of multimodal analgesia strategies. The effects of these two regional block techniques were evaluated in this terms of postoperative NRS scores, opioid consumption, time to first rescue analgesia, and length of hospital stay. This is a retrospective clinical study including 60 patients aged 18–65 years with ASA scores between I and III who underwent elective laparoscopic cholecystectomy. The patients were divided into two groups: those who received the M-TAPA block (n=30) and those who received the ESP block (n=30). All patients were administered 50 mg of intravenous dexketoprofen and 4 mg of ondansetron approximately 30 minutes before the end of the operation. Data regarding postoperative NRS scores, time to first rescue analgesia, 24-hour opioid consumption, duration of hospitalization, time to first mobilization and bowel movement, and postoperative nausea and vomiting (PONV) were obtained from patient records. Postoperative NRS scores at all time points were found to be similar between the two groups, with no statistically significant differences. Although the M-TAPA group showed lower NRS scores at the 4th and 6th hours and a longer time to first rescue analgesia, these differences were not statistically significant. Moreover, M-TAPA, which can be performed in the supine position, was found to be superior to the ESP block in terms of ease of application and shorter procedure time. While M-TAPA appeared more practical and safer with respect to duration and potential complications, both block techniques demonstrated comparable analgesic efficacy. In conclusion, M-TAPA and ESP blocks are effective, reliable regional techniques that may contribute to reduced opioid consumption in postoperative pain management following laparoscopic cholecystectomy. Keywords: ESP, M-TAPA, laparoscopic cholecystectomy, postoperative pain