Postoperative analgesic efficacy of intertransverse process block vs. erector spinae plane block in total laparoscopic hysterectomy: a randomized double-blind trial - Report - MDSpire

Postoperative analgesic efficacy of intertransverse process block vs. erector spinae plane block in total laparoscopic hysterectomy: a randomized double-blind trial

  • By

  • Yang Zeng

  • Qian Chen

  • Huimin Peng

  • Di Wu

  • Shangshi Ji

  • Huan Li

  • Feiyun Lu

  • Haiyun Du

  • Bin Qian

  • June 5, 2026

  • 0 min

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Clinical Report: Comparative Analysis of ITPB and ESPB for Pain Management

Overview

This study compares the analgesic effects of intertransverse process block (ITPB) and erector spinae plane block (ESPB) in patients undergoing total laparoscopic hysterectomy (TLH).

Background

Postoperative pain management is crucial following total laparoscopic hysterectomy (TLH), as patients often experience significant visceral pain. Traditional opioid-based analgesia can lead to adverse effects, prompting the exploration of regional anesthesia techniques like ITPB and ESPB.

Data Highlights

OutcomeITPB GroupESPB GroupMean Difference (95% CI)p-value
Intraoperative remifentanil doseLowerHigher−328.0 μg (−395.2 to −260.9)< 0.001
Cumulative opioid consumption (24 h)LowerHigher−2.5 mg (−3.85 to −1.15)< 0.001
NRS scores for visceral painLowerHigherSignificant at multiple time points< 0.001
NRS scores for incisional painLowerHigherSignificant at multiple time points< 0.05

Key Findings

  • ITPB reduced intraoperative remifentanil doses compared to ESPB.
  • Cumulative opioid consumption within 24 hours was lower in the ITPB group.
  • NRS scores for visceral pain were lower in the ITPB group at multiple postoperative time points.
  • NRS scores for incisional pain were lower in the ITPB group immediately after awakening and at several hours postoperatively.

Clinical Implications

The findings indicate a potential difference in efficacy between ITPB and ESPB for managing postoperative pain in patients undergoing TLH.

Conclusion

ITPB is associated with lower opioid use compared to ESPB in the context of total laparoscopic hysterectomy.

Related Resources & Content

  1. Author(s)/Org, Source, Year -- Title
  2. Response to the editorial on "Comparative analysis of two-stage laparoscopic transversus abdominis plane block versus thoracic epidural anesthesia in bowel resection—an exploratory cohort investigation
  3. Frontiers in Pediatrics — Erector spinae plane block for opioid sparing in children undergoing laparoscopic appendectomy: a randomized controlled trial
  4. Obesity Surgery — Evaluation of Ultrasound-Assisted External Oblique Intercostal Plane Block for Managing Postoperative Pain Following Laparoscopic Sleeve Gastrectomy: A Prospective, Randomized, Controlled Study with Blinded Patients and Observers
  5. Obesity Surgery (Springer) — Comparison of Erector Spinae Plane Block and Intravenous Lidocaine in Opioid-Free Anesthesia for Laparoscopic Sleeve Gastrectomy: A Randomized Controlled Trial
  6. Clinical Obstetrics and Gynecology
  7. Erector spinae plane block for opioid sparing in children undergoing laparoscopic appendectomy: a randomized controlled trial
  8. Evaluation of Ultrasound-Assisted External Oblique Intercostal Plane Block for Managing Postoperative Pain Following Laparoscopic Sleeve Gastrectomy
  9. Frontiers | Postoperative analgesic efficacy of intertransverse process block vs. erector spinae plane block in total laparoscopic hysterectomy: a randomized double-blind trial
  10. Intertransverse process block: A narrative review - ScienceDirect

Original Source(s)

Postoperative analgesic efficacy of intertransverse process block vs. erector spinae plane block in total laparoscopic hysterectomy: a randomized double-blind trial

  • by Yang Zeng, Qian Chen, Huimin Peng, Di Wu, Shangshi Ji, Huan Li, Feiyun Lu, Haiyun Du, Bin Qian

  • June 5, 2026

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