Comparative Evaluation of Bilateral Erector Spinae Plane Block using Bupivacaine combined with Magnesium Sulphate or Clonidine as an adjuvant for Postoperative Analgesia in Laparoscopic Cholecystectomy – A Prospective Randomized Controlled Trial.

Document Type : Original Article

Authors

1 Department of Anesthesiology, SGPGIMS Lucknow, INDIA

2 Department of Anesthedsilogy IMS BHU, Varanasi

3 Department of Anesthesiology, Banaras Hindu University IMS BHU

Abstract

Background:

Laparoscopic cholecystectomy (LC) poses a challenge with postoperative pain, despite multimodal analgesic strategies. The ultrasound guided Erector Spinae Plane (ESP) block is an innovative technique, known for providing thoracic and abdominal analgesia, that offers promising results. This randomized trial investigates the impact of adding magnesium sulphate (MgSO4) or clonidine to 0.25% bupivacaine in bilateral erector spinae blocks for LC postoperative pain management.



Results:

Groups M and C, augmented with MgSO4 and clonidine, respectively, exhibited a predominant age of 51-60, while Group L skewed towards 20-30-year-olds. Mean age was consistent, with a male majority. Baseline measurements showed Group L with the highest preoperative heart rate and Group C with the highest mean arterial pressure (MAP). Postoperatively, Group L had the highest heart rate at 1, 6, and 12 hours, while Group M displayed this trend at 24 hours. Elevated MAP was noted in Group M (at 1 and 12 hours) and Group C (at 6 and 24 hours). Postoperative nausea and vomiting (PONV) rates were comparable. Notable differences were seen in pain scores and rescue analgesia requirements.



Conclusion:

In this prospective trial, bilateral ESP with MgSO4 or clonidine with bupivacaine adjuvants were evaluated for LC postoperative analgesia. Both adjuvants proved effective, with MgSO4 demonstrating favorable hemodynamic stability. These findings advocate tailored analgesic approaches, emphasizing the potential of ESP with specific adjuvants for enhanced LC postoperative pain care. This investigation provides valuable insights for refining pain management strategies in this common surgical procedure, contributing to improved patient care and optimized outcomes.

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