Optimal Patient Positioning for Erector Spinae Plane Block in Laparoscopic Cholecystectomy: (ESP-POSTURE)

Harran University

Status: Enrolling

Conditions: Postoperative Pain; Anesthesia, Regional; Laparoscopic Cholecystectomy; Pain Management

Treatments: Procedure: Erector Spinae Plane (ESP) Block

Study type: Interventional

Funder types: Other

Identifiers

NCT07018258

Cevher

Details and patient eligibility

About

This randomized clinical study aims to compare the postoperative analgesic efficacy, analgesic consumption, and patient satisfaction of erector spinae plane (ESP) block administered in three different patient positions-lateral, prone, and sitting-in individuals undergoing elective laparoscopic cholecystectomy. The study also evaluates the variation in skin-to-block site distance depending on patient positioning.

Full description

Erector spinae plane (ESP) block is a relatively recent regional anesthesia technique performed under ultrasound guidance, widely used for managing acute postoperative pain. While the ESP block is known for its safety, simplicity, and versatility, there is limited evidence regarding the influence of patient positioning on its clinical effectiveness and technical performance.

This prospective, randomized, single-blind study investigates the impact of administering bilateral ESP block at the T7 vertebral level in three different patient positions: lateral decubitus, prone, and sitting. The study includes adult patients (aged 18-65, ASA I-II) undergoing elective laparoscopic cholecystectomy under general anesthesia.

Primary outcomes include postoperative pain scores (VAS and NRS). Secondary outcomes include total rescue analgesic consumption (tramadol), time to first analgesic requirement, patient satisfaction scores (Likert scale), and measurement of the skin-to-block site distance across different positions. Data will be collected at defined intervals up to 24 hours postoperatively.

The findings are expected to inform clinicians on the optimal patient positioning for ESP block to enhance block efficacy and patient comfort during laparoscopic abdominal surgery.

Enrollment: 120 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age between 18 and 65 years
• Scheduled for elective laparoscopic cholecystectomy
• ASA physical status I-II
• Ability to understand and provide written informed consent

Exclusion criteria

• Allergy to local anesthetics
• History of chronic opioid use or substance abuse
• Coagulopathy or current anticoagulant therapy
• Local infection at the block site
• Severe spinal deformities or scoliosis
• BMI > 35 kg/m²
• Pregnancy or breastfeeding
• Refusal to participate in the study

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

---

120 participants in 3 patient groups

Lateral Position Group

Experimental group

Description:

Patients in this group will receive bilateral erector spinae plane (ESP) block at the T7 level in the lateral decubitus position under ultrasound guidance before laparoscopic cholecystectomy.

Treatment:

Procedure: Erector Spinae Plane (ESP) Block

Prone Position Group

Experimental group

Description:

Patients in this group will receive bilateral erector spinae plane (ESP) block at the T7 level in the lateral decubitus position under ultrasound guidance before laparoscopic cholecystectomy.

Treatment:

Procedure: Erector Spinae Plane (ESP) Block

Sitting Position Group

Experimental group

Description:

Patients in this group will receive bilateral erector spinae plane (ESP) block at the T7 level in the lateral decubitus position under ultrasound guidance before laparoscopic cholecystectomy.

Treatment:

Procedure: Erector Spinae Plane (ESP) Block