EP174 Comparison of post-operative analgesic efficacy of continuous erector spinae plane block with continuous epidural analgesia in renal transplant recipient surgery- a randomized, open label, non-inferiority trial (interim data analysis)

Background and Aims Erector Spinae block has been used successfully for postoperative analgesia in Renal Transplant patients. 1 2 Erector Spinae block analgesia has performed well when compared to Epidural analgesia.3 This study includes comparison of efficacy of continuous erector spinae plane block via catheter versus continuous epidural block via catheter for post operative analgesia in patients undergoing renal transplant recipient surgery. This is interim data of the ongoing trial.Methods We conducted randomized, open label, non-inferiority trial in patients aged 18- 60 of ASA III of either sex undergoing renal transplant surgery under general anaesthesia. Patient were randomized on basis of Computer-generated random number table. Group 1 patients received continuous erector spinae block via catheter while group 2 patients received continuous epidural analgesia via catheter. Anaesthetic plan and dosages were uniform across both groups. Fentanyl IV PCA was instituted for all patients in postoperative period. Primary outcome was total fentanyl IV PCA consumption in 48-hrs post extubation. Secondary outcomes were Static and Dynamic pain scores at 30 min. 2 hr, 24 hr and 48 hr time points along with patient satisfaction with analgesia.Results The interim study data includes 44 patients, out of which three were dropouts due to catheter dislodgement and PCA pump malfunction. Fentanyl IV PCA consumption was significantly higher in ES group(n=23) compared to Epidural group (n=18) (ES 1152.33± 575.03 mcg vs Epi 429.00 ± 103.06 mcg, p=0.001). Static & Dynamic pain scores were significantly higher in ES group compared to Epidural group at 30 min and 2 hr. time points, and they were comparable across both groups at other time points. Ambulation times were comparable in both groups. Satisfaction with analgesia was significantly higher in Epidural group compared to ES group.Conclusions According to interim data, Epidural group reported lower Fentanyl consumption and pain scores and better satisfaction with analgesia compared to ES group.