Ultrasound-guided erector spinae plane block versus oblique subcostal transverse abdominis plane block for postoperative analgesia and stress response in inguinal herniorrhaphy

Abstract

Background Hernia of the inguinal region is a common ailment that frequently necessitates surgical intervention. Inguinal hernia repair is linked to substantial pain after the surgery and a potential for the occurrence of persistent pain in the long run. The increased utilization of ultrasonography in anesthesiology departments has led to the development of novel regional block technology in clinical settings. Aim Compare between ultrasound-guided erector spinae plane block (ESPB) and oblique subcostal transverse abdominis plane block (OSTAPB) for patients undergoing inguinal hernia repair regarding the quality of anesthesia as the primary outcome. Patients and methods Fifty-six patients were recruited and were randomized to receive ultrasound-guided ESPB or OSTAPB after induction of general anesthesia. The main outcome was the quality of anesthesia and the stress response (cortisol level) between the two techniques. The secondary outcomes were the duration of sensory block, changes in intraoperative hemodynamics, total amount of rescue analgesia, and incidence of complications. Results In the current study, at 8 and 12 h postoperative, the visual analog scale score was statistically significantly higher in the OSTAPB group. The percentage of cases that required rescue analgesia and the total dose of rescue analgesia were significantly higher in the OSTAPB group. After the surgery, the cortisol level was significantly higher in the OSTAPB group. Conclusion Ultrasound-guided ESPB improved analgesic control by decreasing postoperative pain score and reducing postoperative rescue analgesia intake. Also, the same technique was associated with lower stress response.