Comparison of the postoperative analgesic efficacy of subcostal oblique tap block and erector spinae plane block in laparoscopic cholecystectomy cases

OBJECTIVE: This study aimed to compare the postoperative VAS scores and additional analgesic requirements of the erector spinae plane (ESP) block and the oblique subcostal transversus abdominis plane (STAP) block performed under ultrasound guidance in laparoscopic cholecystectomy (LC) operations. MATERIALS AND METHODS: This study was designed as a randomized double-blind trial. Seventy-eight patients scheduled for laparoscopic cholecystectomy were randomly divided into two groups. In the ESP group (n=38), a unilateral ESP block was performed at the T8 level. In the STAP group (n=40), a unilateral block was also applied. Systolic and diastolic blood pressure, heart rate, VAS score, additional analgesic requirement, length of hospital stay, and postoperative complications were recorded. Data were analyzed using the SPSS 27.0 statistical software. RESULTS: In both groups, VAS scores decreased and additional analgesic requirements were reduced during the 24-hour follow-up period (p<0.001). The decrease in VAS scores was significant in both groups at the end of 24 hours; however, there was no significant difference between the groups at the preoperative, 6th, and 12th hours, while a borderline significance was observed at the 24th hour (p=0.076). The need for additional analgesics significantly decreased in both groups during the 24-hour follow-up (p<0.001). At the 6th hour, the additional analgesic requirement was lower in the STAP group compared to the ESP group, but this difference disappeared over time as the need for analgesics decreased. When total tramadol consumption was examined, tramadol requirement decreased over time during the 24-hour follow-up, and no patient in the STAP group required tramadol at the end of 24 hours. No postoperative nausea or vomiting was observed in any patient. In our study, both blocks were applied unilaterally, and no local anesthetic systemic toxicity (LAST) was detected during the 24-hour postoperative follow-up. CONCLUSION: In this study, lower postoperative VAS scores were observed in both ESP and STAP block groups, and both blocks reduced the need for additional analgesics. It was found that the STAP block was more effective in reducing VAS scores in the early postoperative period, while the ESP block was more effective in the long term. Since unilateral STAP and ESP blocks provide effective analgesia and reduce postoperative analgesic consumption, both methods can be preferred as part of multimodal analgesia. It was determined that analgesic requirements decreased and VAS scores were reduced during follow-up in both groups. We concluded that both blocks can be effectively used for postoperative analgesia in laparoscopic cholecystectomy operations. Key Words: Erector Spinal Plane (ESP) Block, Subcostal Transversusu Abdominis Plane (STAP) Block, Laparoscopic Cholecystectomy, Postoperative Analgesia