Bilateral erector spinae plane block versus thoracic epidural analgesia in living- donor hepatectomies

Background We aimed to compare the effects of bilateral ESPB and thoracic epidural analgesia (TEA) on postoperative pain management and early recovery parameters in patients undergoing living-donor hepatectomy. Material and methods Patients donor hepatectomy from January 2020 to December 2022 were included in this study. They were divided into two groups: ‘group 1’ (TEA) and ‘group 2’ (ESPB). The primary outcome was analgesic efficacy based on the visual analogue scale (VAS), patient-controlled analgesia (PCA) metrics and the necessity of additional morphine administration. The secondary outcomes were the presence of nausea and vomiting, administration of additional antiemetic medication and dose, occurrence of pruritus, presence of gas/stool output, presence of urinary retention, first ambulation time, time of oral intake, Bromage score (leg movements are used to evaluate the efficacy of motor block and lower limb strength), and level of consciousness. Results Both groups exhibited similar demographic characteristics. While the overall VAS score was comparable between the groups, the scores at 1st and 3rd hours were statistically lower in the TEA group. The local anaesthetic dose administered via the PCA pump at six postoperative time points was consistently lower in ESPB group at each interval. No significant differences were observed in opioid consumption, opioid-related side effects, and postoperative early recovery parameters. Conclusions Compared with TEA, ESPB showed promise in effectively managing postoperative analgesia, while maintaining opioid consumption.