Abstract
Introduction: Bariatric surgery advocates multimodal analgesia, discouraging opioid use to minimize side effects such as nausea and vomiting during postoperative pain management for quicker recovery. Combining erector spinae plane block (ESPB) with multimodal analgesia aims to reduce opioid consumption, improving postoperative recovery. This study aimed to compare morphine consumption between patients with morbid obesity undergoing laparoscopic bariatric surgery with and without ESPB.
Methods: This study enrolled 91 patients with morbid obesity who underwent laparoscopic bariatric surgery involving either sleeve gastrectomy or gastric bypass. Of these, 63 patients were included in this study. The participants were randomly allocated to either the intervention group, which received an ESPB before the standard anesthesia protocol, or the control group without any pre-anesthesia block. The primary outcome measured was 24-h morphine consumption via a patient-controlled analgesia machine. Secondary outcomes included patients' satisfaction, postoperative numerical rating score, changes over time, and quality of recovery (QoR) using the Thai QoR-35 score.
Results: We found no statistically significant difference in morphine consumption between the intervention group, which received an ESPB before the standard anesthesia protocol, and the control group without any pre-anesthesia block. Furthermore, our analysis revealed no significant differences in patient satisfaction, postoperative numeric rating score, or QoR across all five aspects evaluated using the Thai QoR-35 score.
Conclusion: ESPB did not reduce morphine consumption and quality of recovery during laparoscopic bariatric surgery. Further studies are required to confirm and identify the reason of the ineffectiveness.