A comparison of ultrasound-guided erector spinae plane block and epidural anesthesia for postoperative recovery in elderly individuals following laparoscopic gastrectomy: a randomized controlled trial

Abstract Background Erector spinae plane block (EspB) is increasingly being applied for laparoscopic radical gastrectomy as an analgesic supplement to general anesthesia. The aim of this study was to evaluate the analgesic efficacy and postoperative recovery outcomes of EspB and epidural anesthesia...

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Main Authors: Cancan Wang, Jie Song, Song Tong, Yun Li, Jin Jiang, Minghan Sheng, Xianwen Hu
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Anesthesiology
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Online Access:https://doi.org/10.1186/s12871-025-03265-x
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author Cancan Wang
Jie Song
Song Tong
Yun Li
Jin Jiang
Minghan Sheng
Xianwen Hu
author_facet Cancan Wang
Jie Song
Song Tong
Yun Li
Jin Jiang
Minghan Sheng
Xianwen Hu
author_sort Cancan Wang
collection DOAJ
description Abstract Background Erector spinae plane block (EspB) is increasingly being applied for laparoscopic radical gastrectomy as an analgesic supplement to general anesthesia. The aim of this study was to evaluate the analgesic efficacy and postoperative recovery outcomes of EspB and epidural anesthesia (EDA) in elderly patients (above 65 years-of-age) undergoing laparoscopic gastrectomy in order to determine the precise multimodal analgesia (PMA) that promotes postoperative recovery. Methods In total, 102 patients assigned for elective laparoscopic gastrectomy were classified into three groups: preoperative bilateral EspB with general anesthesia, EDA with general anesthesia, and general anesthesia alone. The primary outcome, quality-of -recovery (QoR), was evaluated by the QoR-15 questionnaire at T1 (24 h postoperatively). Secondary endpoints included pain scores; postoperative recovery at T0 (1 day before surgery), T2 (3 days postoperatively), and T3 (7 days postoperatively); intraoperative hypotension; opioid consumption; gastrointestinal recovery; and side effects. Results QoR-15 scores for both EspB and EDA were significantly higher than that for general anesthesia alone at T1 (112.09 ± 6.56 and 110.32 ± 5.51a vs. 102.74 ± 4.91 P < 0.001) and T2 (114.79 ± 5.69 and 114.62 ± 6.24 vs. 110.85 ± 4.49 P < 0.05). In addition, both EspB and EDA reduced VAS scores with regards to resting and activity pain at T1(4 ( 2 ) vs. 4 ( 2 ) vs. 4.5 ( 1 ) and 4 ( 1 ) vs. 4( 1 ) vs. 5 ( 1 ), respectively P < 0.05). EspB was associated with reduced postoperative nausea and vomiting than EDA (P < 0.05). Conclusion EspB provides effective analgesia with fewer side effects, such as nausea and vomiting, compared to EDA, and may be a valuable component of multimodal analgesia for improving postoperative recovery in elderly patients undergoing laparoscopic gastric cancer surgery with general anesthesia. Trial registration chictr2400079956 (January 17, 2024).
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spelling doaj-art-01ee40f040dc4fd49f2e571ddb0e4b4b2025-08-20T03:46:19ZengBMCBMC Anesthesiology1471-22532025-07-0125111210.1186/s12871-025-03265-xA comparison of ultrasound-guided erector spinae plane block and epidural anesthesia for postoperative recovery in elderly individuals following laparoscopic gastrectomy: a randomized controlled trialCancan Wang0Jie Song1Song Tong2Yun Li3Jin Jiang4Minghan Sheng5Xianwen Hu6Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital of Anhui Medical UniversityDepartment of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital of Anhui Medical UniversityDepartment of Anesthesiology, Taixing People′s HospitalDepartment of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital of Anhui Medical UniversityDepartment of Anesthesiology, Taixing People′s HospitalDepartment of Anesthesiology, Taixing People′s HospitalDepartment of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital of Anhui Medical UniversityAbstract Background Erector spinae plane block (EspB) is increasingly being applied for laparoscopic radical gastrectomy as an analgesic supplement to general anesthesia. The aim of this study was to evaluate the analgesic efficacy and postoperative recovery outcomes of EspB and epidural anesthesia (EDA) in elderly patients (above 65 years-of-age) undergoing laparoscopic gastrectomy in order to determine the precise multimodal analgesia (PMA) that promotes postoperative recovery. Methods In total, 102 patients assigned for elective laparoscopic gastrectomy were classified into three groups: preoperative bilateral EspB with general anesthesia, EDA with general anesthesia, and general anesthesia alone. The primary outcome, quality-of -recovery (QoR), was evaluated by the QoR-15 questionnaire at T1 (24 h postoperatively). Secondary endpoints included pain scores; postoperative recovery at T0 (1 day before surgery), T2 (3 days postoperatively), and T3 (7 days postoperatively); intraoperative hypotension; opioid consumption; gastrointestinal recovery; and side effects. Results QoR-15 scores for both EspB and EDA were significantly higher than that for general anesthesia alone at T1 (112.09 ± 6.56 and 110.32 ± 5.51a vs. 102.74 ± 4.91 P < 0.001) and T2 (114.79 ± 5.69 and 114.62 ± 6.24 vs. 110.85 ± 4.49 P < 0.05). In addition, both EspB and EDA reduced VAS scores with regards to resting and activity pain at T1(4 ( 2 ) vs. 4 ( 2 ) vs. 4.5 ( 1 ) and 4 ( 1 ) vs. 4( 1 ) vs. 5 ( 1 ), respectively P < 0.05). EspB was associated with reduced postoperative nausea and vomiting than EDA (P < 0.05). Conclusion EspB provides effective analgesia with fewer side effects, such as nausea and vomiting, compared to EDA, and may be a valuable component of multimodal analgesia for improving postoperative recovery in elderly patients undergoing laparoscopic gastric cancer surgery with general anesthesia. Trial registration chictr2400079956 (January 17, 2024).https://doi.org/10.1186/s12871-025-03265-xErector spinae plane blockEpidural anesthesiaPostoperative recoveryLaparoscopic gastrectomy
spellingShingle Cancan Wang
Jie Song
Song Tong
Yun Li
Jin Jiang
Minghan Sheng
Xianwen Hu
A comparison of ultrasound-guided erector spinae plane block and epidural anesthesia for postoperative recovery in elderly individuals following laparoscopic gastrectomy: a randomized controlled trial
BMC Anesthesiology
Erector spinae plane block
Epidural anesthesia
Postoperative recovery
Laparoscopic gastrectomy
title A comparison of ultrasound-guided erector spinae plane block and epidural anesthesia for postoperative recovery in elderly individuals following laparoscopic gastrectomy: a randomized controlled trial
title_full A comparison of ultrasound-guided erector spinae plane block and epidural anesthesia for postoperative recovery in elderly individuals following laparoscopic gastrectomy: a randomized controlled trial
title_fullStr A comparison of ultrasound-guided erector spinae plane block and epidural anesthesia for postoperative recovery in elderly individuals following laparoscopic gastrectomy: a randomized controlled trial
title_full_unstemmed A comparison of ultrasound-guided erector spinae plane block and epidural anesthesia for postoperative recovery in elderly individuals following laparoscopic gastrectomy: a randomized controlled trial
title_short A comparison of ultrasound-guided erector spinae plane block and epidural anesthesia for postoperative recovery in elderly individuals following laparoscopic gastrectomy: a randomized controlled trial
title_sort comparison of ultrasound guided erector spinae plane block and epidural anesthesia for postoperative recovery in elderly individuals following laparoscopic gastrectomy a randomized controlled trial
topic Erector spinae plane block
Epidural anesthesia
Postoperative recovery
Laparoscopic gastrectomy
url https://doi.org/10.1186/s12871-025-03265-x
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