Comparison of the effects of different anesthesia block methods on postoperative analgesia in laparoscopic surgery

OBJECTIVE: In this study, it was aimed to compare the postoperative analgesic efficacy, duration of block application, postoperative nausea and vomiting of thoracic paravertebral block with the erector spina plan block which performed by ultrasonography guidence in elective laparoscopic cholecystectomy cases. MATERIALS AND METHODS: The study was designed as a randomized controlled prospective study. 102 patients undergoing elective laparoscopic cholecystectomy were divided into Group I and Group II using www.randomizer.org. Patients who had thoracal paravertebral block were registered as Group I and who had erector spina plane block were registered as Group II. Blocks were performed unilaterally with USG guidance in both groups. Block application times and postoperative nausea and vomiting datas were recorded for both blocks. Postoperative VPS scores, presence of nausea, vomiting, additional analgesic requirement up to 24 hours and developed complications were recorded. Statistically, p <0.05 was considered significant. RESULTS: A total of 102 patients were evaluated, including 51 patients in the ESPB group and 51 patients in the TPVB group. No statistically significant difference was found in demographic (age, body mass index, ASA class, operation time) findings of the patients except gender. Satisfaction score was found significantly higher in the TPVB group. VPS scores of the cases at 0, 2, 4, 8, 12, 24 hours was not differ statistically. When nausea and vomiting, complication rates and postoperative first analgesia needs were compared, no significant difference was found between the two groups. Serious complications such as local anesthetic toxicity and pneumothorax were not encountered. CONCLUSİON: We concluded that TPVB and ESPB applied with USG guidance in laparoscopic cholecystectomies are not superior to each other in terms of postoperative analgesic efficacy. ESPB is an effective and feasible block, since it is easy to apply and has less risks such as pneumothorax. We believe that it is a good alternative to TPVB for postoperative pain control due to the quality of analgesia and ease of application.