Erector spinae plane block vs transversus abdominis plane block for visceral and somatic pain after laparoscopic appendectomy

Table 1 Comparison of baseline characteristics between groups, mean ± SD/n (%)

Variable	ESPB group (n = 91)	TAPB group (n = 92)	t/χ2/Z value	P value
Age (years)	42.3 ± 12.6	41.8 ± 13.1	0.263	0.793
Sex			0.132	0.716
Male	49 (53.8)	52 (56.5)
Female	42 (46.2)	40 (43.5)
BMI (kg/m²)	23.8 ± 3.2	24.1 ± 3.4	-0.61	0.543
ASA classification			-0.426	0.67
Class I	34 (37.4)	32 (34.8)
Class II	48 (52.7)	52 (56.5)
Class III	9 (9.9)	8 (8.7)
Appendicitis type			0.059	0.808
Acute appendicitis	78 (85.7)	80 (87.0)
Chronic appendicitis	13 (14.3)	12 (13.0)
Pathological classification			0.155	0.925
Simple	31 (34.1)	29 (31.5)
Suppurative	47 (51.6)	50 (54.3)
Gangrenous	13 (14.3)	13 (14.2)
Nature of surgery			0.011	0.916
Elective	26 (28.6)	27 (29.3)
Emergency	65 (71.4)	65 (70.7)
Operative time (minutes)	58.4 ± 15.2	56.9 ± 14.8	0.68	0.497
Pneumoperitoneum duration (minutes)	45.6 ± 12.3	44.2 ± 11.9	0.787	0.432
Intraoperative blood loss (mL)	15.0 (10.0, 25.0)	15.0 (10.0, 20.0)	-0.524	0.6
Intraoperative remifentanil consumption (μg)	312.5 ± 68.4	305.8 ± 71.2	0.651	0.516

BMI: Body mass index; ASA: American Society of Anesthesiologists; ESPB: Erector spinae plane block; TAPB: Transversus abdominis plane block.

Table 2 Comparison of postoperative visceral pain Visual Analog Scale scores between groups at different time points (scores), mean ± SD

Time point	State	ESPB group (n = 91)	TAPB group (n = 92)	t value	P value
2 hours postoperatively	Rest	2.1 ± 0.8	3.2 ± 0.9	-8.741	< 0.001
	Activity	2.8 ± 0.9	4.0 ± 1.0	-8.648	< 0.001
6 hours postoperatively	Rest	2.3 ± 0.7	3.1 ± 0.8	-7.275	< 0.001
	Activity	3.0 ± 0.8	3.9 ± 0.9	-7.243	< 0.001
12 hours postoperatively	Rest	1.9 ± 0.6	2.4 ± 0.7	-5.237	< 0.001
	Activity	2.5 ± 0.7	3.1 ± 0.8	-5.479	< 0.001
24 hours postoperatively	Rest	1.4 ± 0.5	1.5 ± 0.6	-1.242	0.216
	Activity	1.9 ± 0.6	2.0 ± 0.7	-1.055	0.293
48 hours postoperatively	Rest	0.8 ± 0.4	0.9 ± 0.5	-1.517	0.131
	Activity	1.2 ± 0.5	1.3 ± 0.5	-1.38	0.169

Repeated measures ANOVA for rest state: Time effect F (2.87, 519.57) = 254.38, P < 0.001; group effect F (1, 181) = 52.16, P < 0.001; interaction effect F (2.87, 519.57) = 16.82, P < 0.001 (Greenhouse-Geisser corrected); repeated measures ANOVA for activity state: Time effect F (2.92, 528.52) = 278.65, P < 0.001; group effect F (1, 181) = 48.73, P < 0.001; interaction effect F (2.92, 528.52) = 15.94, P < 0.001 (Greenhouse-Geisser corrected).

ESPB: Erector spinae plane block; TAPB: Transversus abdominis plane block.

Table 3 Comparison of postoperative somatic pain Visual Analog Scale scores between groups at different time points (scores), mean ± SD

Time point	State	ESPB group (n = 91)	TAPB group (n = 92)	t value	P value
2 hours postoperatively	Rest	2.4 ± 0.8	2.3 ± 0.9	0.798	0.426
	Activity	3.5 ± 1.0	3.4 ± 1.1	0.649	0.517
6 hours postoperatively	Rest	2.2 ± 0.7	2.1 ± 0.8	0.905	0.367
	Activity	3.2 ± 0.9	3.1 ± 0.9	0.754	0.452
12 hours postoperatively	Rest	1.8 ± 0.6	1.7 ± 0.7	1.054	0.293
	Activity	2.6 ± 0.8	2.5 ± 0.8	0.853	0.395
24 hours postoperatively	Rest	1.3 ± 0.5	1.2 ± 0.5	1.369	0.173
	Activity	1.9 ± 0.6	1.8 ± 0.6	1.133	0.259
48 hours postoperatively	Rest	0.7 ± 0.4	0.7 ± 0.4	0	1
	Activity	1.1 ± 0.5	1.0 ± 0.5	1.351	0.178

Repeated measures ANOVA for rest state: Time effect F (2.79, 505.01) = 298.72, P < 0.001; group effect F (1, 181) = 0.76, P = 0.384; interaction effect F (2.79, 505.01) = 0.38, P = 0.798 (Greenhouse-Geisser corrected); repeated measures ANOVA for activity state: Time effect F (2.85, 515.85) = 326.41, P < 0.001; group effect F (1, 181) = 0.89, P = 0.347; interaction effect F (2.85, 515.85) = 0.52, P = 0.712 (Greenhouse-Geisser corrected).

ESPB: Erector spinae plane block; TAPB: Transversus abdominis plane block.

Table 4 Comparison of postoperative rescue analgesia between groups

Variable	ESPB group (n = 91)	TAPB group (n = 92)	χ2/Z value	P value
Rescue analgesia, n (%)	12 (13.2)	24 (26.1)	4.768	0.029
Tramadol consumption (mg)	0 (0, 0)	0 (0, 100)	-2.518	0.012

Rescue analgesic medication was tramadol 100 mg intramuscular injection; could be repeated if Visual Analog Scale ≥ 4 points within 48 hours postoperatively, with a maximum of 3 doses.

ESPB: Erector spinae plane block; TAPB: Transversus abdominis plane block.

Table 5 Comparison of postoperative recovery quality indicators between groups, mean ± SD

Variable	ESPB group (n = 91)	TAPB group (n = 92)	t/Z value	P value
Time to first ambulation (hours)	12.4 ± 3.8	13.1 ± 4.2	-1.185	0.238
Time to first flatus (hours)	19.8 ± 5.4	20.5 ± 5.8	-0.854	0.394
Postoperative hospital stay (days)	2.0 (2.0, 3.0)	2.0 (2.0, 3.0)	-0.876	0.381

ESPB: Erector spinae plane block; TAPB: Transversus abdominis plane block.

Table 6 Comparison of postoperative nausea and vomiting between groups, n (%)

Variable	ESPB group (n = 91)	TAPB group (n = 92)	Z/χ2 value	P value
PONV grade			-0.892	0.372
Grade 0	62 (68.1)	58 (63.0)
Grade 1	18 (19.8)	20 (21.7)
Grade 2	8 (8.8)	10 (10.9)
Grade 3	3 (3.3)	4 (4.3)
PONV incidence	29 (31.9)	34 (37.0)	0.516	0.473
Antiemetic use	11 (12.1)	14 (15.2)	0.38	0.538

PONV: Postoperative nausea and vomiting; ESPB: Erector spinae plane block; TAPB: Transversus abdominis plane block.

Table 7 Comparison of patient satisfaction with analgesia between groups

Variable	ESPB group (n = 91)	TAPB group (n = 92)	Z value	P value
Satisfaction score			-2.486	0.013
1 point	1 (1.1)	2 (2.2)
2 points	3 (3.3)	8 (8.7)
3 points	12 (13.2)	18 (19.6)
4 points	48 (52.7)	46 (50.0)

ESPB: Erector spinae plane block; TAPB: Transversus abdominis plane block.