This study aims to compare the ultrasound-guided bilateral erector spinae plane block (ESPB) and oblique subcostal transverse abdominal plane block (OSTAPB) for postoperative analgesia in colorectal surgery.
Age 18 to 75 years old.
Both sexes.
American Society of Anesthesiologists (ASA) physical status II-III.
Scheduled for open colorectal surgery under general anesthesia.
History of opioid abuse.
Chronic opioid consumption.
Body mass index (BMI) ≥ 35 kg/m2.
Severe cardiac insufficiency, defined as New York Heart Association (NYHA) class III or IV heart failure.
Parallel
Erector Spinae Plane Block
Other interventionPatients will receive ultrasound-guided erector spinae plane block.
Oblique Subcostal Transversus Abdominis Plane Block
Other interventionPatients will receive ultrasound-guided oblique subcostal transversus abdominis plane block.
Degree of pain
Each patient will be instructed about postoperative pain assessment with the numeric rating scale (NRS). NRS (0 represents "no pain" while 10 represents "the worst pain imaginable"). NRS will be assessed at 0, 2, 4, 6, 12, and 24 h postoperatively.
Time to the first rescue analgesia
Time to the first request for the rescue analgesia will be recorded from end of surgery to first dose of morphine administrated.
Intraoperative fentanyl consumption
Additional fentanyl bolus dosages of 1 µg/kg IV will be administered if heart rate or mean arterial blood pressure elevated more than 20% of the baseline (after exclusion of other causes than pain).
Total morphine consumption
Rescue analgesia of morphine will be given as 3 mg bolus (maximum dose of 0.5 mg/kg/24hours) if the numeric rating scale (NRS) \> 3 to be repeated after 30 min if pain persists until the NRS \< 4.
Mean arterial pressure
Mean arterial pressure will be recorded at: * T0: Baseline reading preoperatively (in the preoperative holding area). * T1: Immediately before intubation. * T2: 15 minutes after intubation. * T3: 30 minutes after intubation. * T4: 45 minutes after intubation. * T5: 60 minutes after intubation. * T6: At the end of surgery.
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