The Impact of Regional Anesthesia Techniques on Pain Control and Opioid Consumption in Sleeve Gastrectomy

Abstract

This study aims to evaluate the effectiveness of erector spinae block (ESP) and transversus abdominis plane (TAP) blocks in reducing postoperative opioid requirements and enhancing pain control in laparoscopic sleeve gastrectomy (LSG) patients. This retrospective study included 90 patients undergoing LSG. The patients were equally allocated into three groups—ESP block, TAP block, and control (no regional anesthesia applied)—with 30 patients in each group. During the allocation process, patients were matched for age and gender. Pain levels were assessed using the Visual Analog Scale (VAS) at 0, 2, 4, 8, 12, and 24 hours postoperatively. Opioid consumption, side effects, patient, and surgeon satisfaction were recorded. Statistical analyses were conducted to compare pain scores, opioid use, and satisfaction levels among the groups. The ESP block group reported the lowest VAS scores, indicating superior pain control. Opioid consumption was significantly reduced in both ESP and TAP block groups compared to the control group, with the ESP group showing the greatest reduction. There was a significant relationship between the amount of opioid used and side effects. Patient satisfaction was highest in the ESP block group, followed by the TAP block group, and lowest in the control group. The ESP and TAP blocks are effective in reducing postoperative opioid consumption and providing better pain control in LSG patients. The ESP block, in particular, offers superior analgesia and higher patient satisfaction compared to the TAP block and no block.

Keywords

• Erector spinae plane block
• laparoscopic sleeve gastrectomy
• opioid consumption
• postoperative pain
• transversus abdominis plane block

Regionel Anestezi Tekniklerinin Sleeve Gastrektomide Ağri Kontrolü ve Opioid Tüketimi Üzerindeki Etkisi

Abstract

Bu çalışma, laparoskopik mide tüpü gastrektomi (LSG) hastalarında erector spinae bloğu (ESP) ve transversus abdominis plane (TAP) bloklarının postoperatif opioid gereksinimlerini azaltma ve ağrı kontrolünü iyileştirme etkinliğini değerlendirmeyi amaçlamaktadır. Bu retrospektif çalışmaya, LSG uygulanan 90 hasta dahil edilmiştir. Hastalar, her bir grup için 30 hasta olacak şekilde üç gruba eşit olarak dağıtılmıştır—ESP bloğu, TAP bloğu ve kontrol (regionel anestezi uygulanmayan)—ve hastalar yaş ve cinsiyet açısından eşleştirilmiştir. Ağrı düzeyleri, postoperatif 0, 2, 4, 8, 12 ve 24 saatlerde Görsel Analog Skala (VAS) kullanılarak değerlendirilmiştir. Opioid tüketimi, yan etkiler, hasta ve cerrah memnuniyeti kaydedilmiştir. Gruplar arasında ağrı skorları, opioid kullanımı ve memnuniyet düzeylerini karşılaştırmak için istatistiksel analizler yapılmıştır. ESP grubu, kontrol grubuna kıyasla anlamlı şekilde daha düşük VAS skorları göstermiştir. ESP bloğu grubunda en düşük VAS skorları bildirilmiş, bu da üstün ağrı kontrolünü göstermektedir. Opioid tüketimi, ESP ve TAP bloğu gruplarında kontrol grubuna göre anlamlı şekilde azalırken, ESP grubunda en büyük azalma gözlemlenmiştir. Kullanılan opioid miktarı ile yan etkiler arasında anlamlı bir ilişki bulunmuştur. Hasta memnuniyeti, en yüksek ESP bloğu grubunda, ardından TAP bloğu grubunda ve en düşük kontrol grubunda kaydedilmiştir. ESP ve TAP blokları, LSG hastalarında postoperatif opioid tüketimini azaltmada ve daha iyi ağrı kontrolü sağlamada etkilidir. Özellikle ESP bloğu, TAP bloğuna ve herhangi bir blok uygulanmayan gruba kıyasla üstün analjezi ve daha yüksek hasta memnuniyeti sunmaktadır.

Keywords

• Erectör spina plane bloğu
• laparoskopik sleeve gastrektomi
• opioid tüketimi
• postoperatif ağrı
• transversus abdominis plane bloğu

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