{
  "abstract": "Background: Super-obese patients undergoing laparoscopic bariatric surgery are at an increased risk of opioid-related respiratory compromise, underscoring the need for opioid-sparing analgesia.\n\nObjectives: To compare bilateral ultrasound-guided thoracic erector spinae plane block (ESPB) and trocar-site local anesthetic infiltration with respect to perioperative opioid consumption and early postoperative pain.\n\nMethods: In this single-center randomized controlled trial, 60 adults aged 18 - 60 years with American Society of Anesthesiologists physical status III and a Body Mass Index (BMI) > 50 kg/m2 who were scheduled for laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass were randomized 1:1 to receive bilateral T7 ESPB with 0.25% bupivacaine (30 mL/side) or trocar-site infiltration with 0.5% bupivacaine (5 mL/site). The primary outcome was cumulative perioperative opioid consumption during the first 24 hours, expressed as an intravenous morphine-equivalent dose. Secondary outcomes included intraoperative fentanyl use, Visual Analog Scale pain scores at rest and during coughing, time to first rescue analgesia, time to ambulation, hemodynamics, the 15-item Quality of Recovery (15-item Quality of Recovery questionnaire (QoR-15)) score at 24 hours, and complications.\n\nResults: ESPB reduced intraoperative fentanyl requirements (56.7% vs 100%; total dose, 50 [25 - 75] vs 100 [100 - 212.5] µg; both P < 0.001) and cumulative 24-hour morphine-equivalent consumption (11 [9.75 - 13] vs 24.5 [22 - 33], mg; P < 0.001). Visual analog scale scores were lower with ESPB at rest at 4 and 8 hours and during coughing within the first 8 hours (all P < 0.001). Erector spinae plane block prolonged the time to first rescue analgesia (8 [8 - 12] vs 4 [4 - 8], h) and enabled earlier ambulation (4.07 ± 0.78 vs 4.60 ± 0.67 h; both P < 0.001). The QoR-15 score was higher with ESPB (118.8 ± 5.35 vs 106.6 ± 3.91; P < 0.001).\n\nConclusions: In super-obese patients, thoracic ESPB provided a clinically meaningful opioid-sparing effect, improved early pain control and quality of recovery, and facilitated earlier mobilization following laparoscopic bariatric surgery.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Anesthesia, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Cairo University Cairo Egypt",
    "Department of Anesthesia Technology, College of Applied Medical Sciences in Jubail, Imam Abdulrahman Bin Faisal University Dammam Saudi Arabia"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Amany A Eissa",
      "orcid": "0009-0005-1912-4024"
    },
    {
      "affs": [
        0
      ],
      "name": "Mostafa Essam Abdelrahman Abdelmohsen",
      "orcid": "0009-0004-7169-457X"
    },
    {
      "affs": [
        0
      ],
      "name": "Marwa Zayed",
      "orcid": "0000-0003-1674-3354"
    },
    {
      "affs": [
        1
      ],
      "name": "Nashwa Nabil Mohamed Talaat",
      "orcid": "0000-0003-2978-6978"
    },
    {
      "affs": [
        0
      ],
      "name": "Mai Ahmed Ali",
      "orcid": "0000-0001-7592-0950"
    },
    {
      "affs": [
        0
      ],
      "name": "Yasmin Hassabelnaby",
      "orcid": "0000-0001-6993-4280"
    },
    {
      "affs": [
        0
      ],
      "name": "Fatma Elzahraa Mohamed Haggag",
      "orcid": "0000-0002-8241-3276"
    },
    {
      "affs": [
        0
      ],
      "name": "Mona Hamed Elsherbiny",
      "orcid": "0000-0001-6925-4330"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6965fx3ad3w49.bib",
  "cited_by": 0,
  "doi": "10.5812/aapm-170030",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13727967/?tool=EBI",
  "id": "6965fx3ad3w49",
  "issns": [
    "2228-7523",
    "2228-7531"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13727967",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research Article"
    ],
    [
      "openalex",
      "2746|Anesthesia and Pain Management"
    ]
  ],
  "openalex": "W7223673037",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13727967/pdf/?tool=EBI",
  "pmcid": "PMC13727967",
  "pmid": "42978760",
  "published": "2026-06-30",
  "publisher": "Brieflands",
  "ris": "https://research.draconitic.com/paper/6965fx3ad3w49.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T15:20:47Z",
      "native_id": "PMC:PMC13727967",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13727967"
    },
    {
      "first_seen": "2026-11-06T12:23:44Z",
      "native_id": "PMC13727967",
      "source": "pmc",
      "url": "https://doi.org/10.5812/aapm-170030"
    }
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Anesthesia and Pain Management",
      "subfield": "surgery"
    }
  ],
  "title": "The Efficacy of Ultrasound-Guided Thoracic Erector Spinae Plane Block for Perioperative Analgesia During Laparoscopic Bariatric Surgery in Super-Obese Patients: A Randomized Controlled Trial",
  "title_text": "The Efficacy of Ultrasound-Guided Thoracic Erector Spinae Plane Block for Perioperative Analgesia During Laparoscopic Bariatric Surgery in Super-Obese Patients: A Randomized Controlled Trial",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T12:23:44Z",
  "url": "https://research.draconitic.com/paper/6965fx3ad3w49",
  "venue": "Anesthesiology and pain medicine",
  "versions": []
}