Abstract
Background: Managing pain following open oncological abdominal surgeries remains a concern due to slow surgical wound healing and reliance on opioids with their side effects. ESP block is a regional anaesthesia technique that have been found as feasible option providing adequate amount of analgesia with minimum side effects as compared to the conventional methods.
Aim: This work was intended to assess the efficiency of ESP block in the control of postoperative pain, in comparison with other common approaches.
Methods: A randomized controlled study was carried out on a sample of one hundred and twenty adult patients scheduled for open oncologic abdominal procedures. Participants were randomized into two groups: intervention group consisted of the ESP block with a defined protocol of bupivacaine usage; the control group used standard opioid pain control. Primary end points were the VAS pain scores and opioid use. Other secondary measurements were time to recovery, side effects and complications. Data were analysed using t-tests and ANOVA, at p < 0.05.
Results: The ESP block group had lower reported pain levels at all postoperative interval times (p < 0.001) and reduced opioid usage by 54 percent compared to the control group (p < 0.001). The average duration of recovery was 1.5 days shorter (p = 0.003); the frequency of side effects from opioids, such as nausea and vomiting, was also lower in the ESP block group (p = 0.001). There were no life threatening consequences that would be linked with the ESP block.
Conclusion: The ESP block is associated with better postoperative pain control, reduced morphine consumption across the entire study period, quicker return to full mobility and gastrointestinal function, and low risk profile. These results provide evidence for the use of the routine implementation of the ESP block in multimodal analgesic regimens for oncologic abdominal surgeries to improve results and minimize opioid use.