Ultrasound-guided oblique subcostal transversus abdominis plane block versus erector spinae plane block as pre-emptive analgesia for open umbilical hernia repair: A comparative, randomized, double-blinded clinical trial

Background and aim
Ultrasound (US) oblique subcostal transversus abdominis plane (OSTAP) block provides excellent pain relief following open umbilical hernia repair. The erector spinae (ES) plane block has recently received a great deal of attention as it is simple to operate. Our research compares US-guided bilateral ES block with bilateral oblique OSTAP block as pre-emptive analgesia.
Patients and methods
This clinical trial included 70 participants of both sexes who were prepared for optional open umbilical hernia repair. Before beginning of the surgical procedure, they received either bilateral US-guided ES block (group E) or bilateral ultrasonic-guided OSTAP block (group T). The primary outcome of our trial was the total morphine intake during the first 24 h postoperatively.
Results
The total amount of morphine consumed (mg) within the first 24 h following the procedure was statistically substantially less in group E than in group T (<0.001). The time it took for the first morphine request in group E (7.4 ± 1.79 h) was statistically insignificantly longer than group T (6.6 ± 1.97). In comparison with group T, there was no significant decrease in intraoperative fentanyl usage in group E (>0.1). Regarding verbal numerical rating scores when compared between the two groups at rest and cough, it was statistically significant lower at 30 min, 2 h, and 4 h (<0.05) in group E than group T. There was no statistical difference between them in the following periods.
Conclusion
Bilateral US-guided ES block offers a powerful analgesia after open umbilical hernia surgery.