COMPARISION OF ANALGESIC EFFICACY OF ROPIVACAINE VERSUS BUPIVACAINE IN ULTRASOUND GUIDED BILATERAL ERECTOR SPINAE BLOCK IN LAPAROSCOPIC CHOLECYSTECTOMY: RANDOMIZED CLINICAL TRIAL

Authors

  • GEETHA S. HASSARADDI Department of Anesthesiology and Critical Care Navodaya Medical College and Research Center, Raichur, Karnataka, India
  • PRATIBHA SD Department of Anaesthesiology, Bldedu Shri B M Patil Medical College, Vijayapura-586103, Karnataka, India https://orcid.org/0000-0002-6528-1814
  • PRASHANTH VADIGERI Department of Anesthesiology and Critical Care Navodaya Medical College and Research Center, Raichur, Karnataka, India
  • SHYNEE JN Department of Anesthesiology and Critical Care Navodaya Medical College and Research Center, Raichur, Karnataka, India https://orcid.org/0009-0007-8664-8455
  • RAMESH BABU Department of Anesthesiology and Critical Care Navodaya Medical College and Research Center, Raichur, Karnataka, India

DOI:

https://doi.org/10.22159/ijcpr.2025v17i4.7026

Keywords:

Ropivacaine, Bupivacaine, Erector spinae plane block, Laparoscopic cholecystectomy

Abstract

Objective: Laparoscopic cholecystectomy (LC) is the primary treatment for cholelithiasis and is minimally invasive surgery, but common adverse effects is post-operative pain. Our study aims to assess the analgesic effect of Erector spinae plane block (ESPB) guided by ultrasound for post-operative pain and the need for rescue analgesia following laparoscopic cholecystectomy.

Methods: Eighty patients were included in the study who were scheduled for laparoscopic cholecystectomy with 40 patients in each group. Patients were randomly assigned to one of the two groups who underwent ESPB prior to surgery: Group B (ESPB with 20 ml of 0.25% Bupivacaine) or Group R (ESPB with 20 ml of 0.375% Ropivacaine). Pain assessment was done for 24 h postoperatively. Patients received Tramadol 1 mg/kg intravenously as a rescue analgesic if their Numerical rating scale (NRS) was ≥4.

Results: Group R had lower mean NRS at 1 h, 3 h, 6 h, and 24 h, and Inj tramadol as rescue analgesia was less than in Group B.

Conclusion: Ropivacaine 0.375% provided better pain relief in post-operative period, lesser need for analgesia, lower dose of Tramadol requirement in comparison to Bupivacaine 0.25% in ultrasound-guided Erector spinae block.

Downloads

Download data is not yet available.

References

1. Alexander JI. Pain after laparoscopy. Br J Anaesth. 1997;79(3):369-78. doi: 10.1093/bja/79.3.369, PMID 9389858.

2. Gerbershagen HJ, Aduckathil S, Van Wijck AJ, Peelen LM, Kalkman CJ, Meissner W. Pain intensity on the first day after surgery: a prospective cohort study comparing 179 surgical procedures. Anesthesiology. 2013;118(4):934-44. doi: 10.1097/ALN.0b013e31828866b3, PMID 23392233.

3. Shin HJ, Oh AY, Baik JS, Kim JH, Han SH, Hwang JW. Ultrasound guided oblique subcostal transversus abdominis plane block for analgesia after laparoscopic cholecystectomy: a randomized controlled observer-blinded study. Minerva Anestesiol. 2014;80(2):185-93. PMID 24193176.

4. Aydin G, Aydin O. The efficacy of ultrasound-guided paravertebral block in laparoscopic cholecystectomy. Medicina (Kaunas). 2018;54(5):75. doi: 10.3390/medicina54050075, PMID 30360531.

5. Altıparmak B, Korkmaz Toker M, Uysal AI, Kusuu Y, Gumus Demirbilek S. Ultrasound guided erector spinae plane block versus oblique subcostal transversus abdominis plane block for postoperative analgesia of adult patients undergoing laparoscopic cholecystectomy: randomized controlled trial. J Clin Anesth. 2019 Nov;57:31-6. doi: 10.1016/j.jclinane.2019.03.012, PMID 30851501.

6. El Ghamry MR, Elgebaly AS, Anwar AG, Shaddad MN. Ultrasound-guided erector spinae plane block for acute pain management in patients undergoing posterior lumbar interbody fusion under general anaesthesia. South Afr J Anaesth Analg. 2019;25(6):26-31. doi: 10.36303/SAJAA.2019.25.6.A4.

7. Singh S, Chaudhary NK. Bilateral ultrasound-guided erector spinae plane block for postoperative pain management in lumbar spine surgery: a case series. J Neurosurg Anesthesiol. 2019;31(3):354. doi: 10.1097/ANA.0000000000000518, PMID 29965831.

8. Gonzalez S, Basora MM, Tio M, Camacho A, Fuster S, Blanch X. L4 erector spinal plane block after lumbar spine arthrodesi: a case series. Rev Esp Anestesiol Reanim. 2019 Dec;66(10):537-42. doi: 10.1016/j.redar.2019.05.004.

9. Jin Y, Zhao S, Cai J, Sun Y, Blessing M, Hu S. Efficacy of ultrasound guided erector spinae plane block for perioperative pain control and short-term outcomes in lumbar laminoplasty. BMJ Yale. 2020;19(7):45. doi: 10.1101/2020.01.30.20019745.

10. Yao Y, Li H, He Q, Chen T, Wang Y, Zheng X. Efficacy of ultrasound guided erector spinae plane block on postoperative quality of recovery and analgesia after modified radical mastectomy: randomized controlled trial. Reg Anesth Pain Med. 2019:rapm-2019-100983. doi: 10.1136/rapm-2019-100983, PMID 31678959.

11. Solanki NA, Korat RR, Shah DV, Patel SK. Evaluation of analgesic efficacy of bupivacaine and ropivacaine given through landmark guided erector spinae plane block for post-operative pain relief in patients undergoing laparoscopic cholecystectomy. Natl J Med Res. 2020 Jul-Sep;10(3):144-7.

12. Sreedhar N, Hemlata MMK, Mehrotra MK, Singh PR, Siddiqui AK, Kohli M. Efficacy of bilateral erector spinae plane block using bupivacaine and ropivacaine for postoperative analgesia following lumbar spine surgeries a randomised clinical study. J Clin Diagn Res. 2021 Sep;15(9):UC19-UC23. doi: 10.7860/JCDR/2021/49463.15397.

13. Sifaki F, Mantzoros I, Koraki E, Bagntasarian S, Christidis P, Theodoraki K. The effect of ultrasound-guided bilateral erector spinae plane block with and without dexmedetomidine on intraoperative and postoperative pain in laparoscopic cholecystectomies: a randomized controlled double blind prospective trial. Pain Physician. 2022 Oct;25(7):E999-E1008. PMID 36288585.

14. Schnabel A, Weibel S, Pogatzki Zahn E, Meyer Frießem CH, Oostvogels L. Erector spinae plane block for postoperative pain. Cochrane Database Syst Rev. 2023;10(10):CD013763. doi: 10.1002/14651858.CD013763.pub2, PMID 37811665.

15. Verma R, Srivastava D, Saxena R, Singh TK, Gupta D, Agarwal A. Ultrasound-guided bilateral erector spinae plane block for postoperative analgesia in laparoscopic cholecystectomy: a randomized controlled trial. Anesth Essays Res. 2020 Apr-Jun;14(2):226-32. doi: 10.4103/aer.AER_41_20, PMID 33487820.

16. Altıparmak B, Korkmaz Toker M, Uysal AI, Kuscu Y, Gumus Demirbilek S. Ultrasound guided erector spinae plane block versus oblique subcostal transversus abdominis plane block for postoperative analgesia of adult patients undergoing laparoscopic cholecystectomy: randomized controlled trial. J Clin Anesth. 2019 Nov;57:31-6. doi: 10.1016/j.jclinane.2019.03.012, PMID 30851501.

Published

15-07-2025

How to Cite

HASSARADDI, GEETHA S., et al. “COMPARISION OF ANALGESIC EFFICACY OF ROPIVACAINE VERSUS BUPIVACAINE IN ULTRASOUND GUIDED BILATERAL ERECTOR SPINAE BLOCK IN LAPAROSCOPIC CHOLECYSTECTOMY: RANDOMIZED CLINICAL TRIAL”. International Journal of Current Pharmaceutical Research, vol. 17, no. 4, July 2025, pp. 94-97, doi:10.22159/ijcpr.2025v17i4.7026.

Issue

Section

Original Article(s)