• Yu Jeong Bang, Eun Kyung Lee, Heejoon Jeong, RyungA Kang, Justin Sangwook Ko, Tae Soo Hahm, You Jin Seong, Yoo-Young Lee, and Ji Seon Jeong.
• Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
• J Clin Anesth. 2024 May 1; 93: 111362111362.

Study ObjectiveTo investigate the analgesic efficacy of erector spinae plane block (ESPB) in major gynecologic surgery, expressed as cumulative opioid consumption 24 h after surgery.DesignA single-center, patient-assessor blinded, randomized controlled study.SettingSamsung medical center (tertiary university hospital), between February 2022 to January 2023.PatientsEighty-eight females undergoing major surgery with long midline incision for gynecologic malignancy.InterventionsPatients were randomly assigned to receive standard systemic analgesia (Control group) or ESPB (ESPB group). ESPB was performed bilaterally at the level of the 9th thoracic vertebra with a mixture of 20 mL of 0.5% ropivacaine and 100 μg of epinephrine.MeasurementsThe primary outcome was cumulative opioid consumption at 24 h postoperatively. Secondary outcomes included opioid consumption and pain severity during the 72 h after surgery. The variables regarding postoperative recovery and patient-centered outcomes were compared.Main ResultsThe mean cumulative opioid consumption 24 h after surgery was 35.8 mg in the ESPB group, which was not significantly different from 41.4 mg in the control group (mean difference, 5.5 mg; 95% CI -1.7 to 12.8 mg; P = 0.128). However, patient satisfaction regarding analgesia was significantly higher in the ESPB group compared with the control group at 24 h postoperative (median difference, -1; 95% CI -3 to 0; P = 0.038). There were no significant differences in the variables associated with postoperative recovery.ConclusionESPB did not reduce opioid consumption during the 24 h postoperative but attenuated pain intensity during the early period after surgery.Copyright © 2023 Elsevier Inc. All rights reserved.

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