Postoperative analgesic effectiveness of erector spinae plane block vs. rectus sheath block: a reply

What is it about?

In response to recent correspondence regarding our study on the effectiveness of erector spinae plane blocks compared to rectus sheath blocks, we assert that the risk of unblinding is minimal due to the anesthesia condition of patients and the absence of postoperative care providers during the interventions. Although we utilized standard measures such as pain scores, total analgesic consumption, and time to first rescue analgesic, we acknowledge the growing emphasis on patient comfort and satisfaction, suggesting the incorporation of the Quality of Recovery (QoR-40) scale. Our findings indicated that patients receiving the erector spinae plane block had significantly lower postoperative pain scores compared to those receiving the rectus sheath block, surpassing the minimal clinically important difference (MCID) threshold at most time points post-surgery. Although the reduction in morphine consumption was statistically significant, it did not meet the MCID threshold due to the employed rescue analgesic protocol and the limitations of the study. We also addressed the critique regarding our sample size calculation, stating that estimates were derived from prior research, which aligns with standard methodological practices. However, we acknowledge that the study may have been underpowered to identify differences in postoperative nausea and vomiting outcomes.

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Why is it important?

In response to recent correspondence regarding our study on the effectiveness of erector spinae plane blocks compared to rectus sheath blocks, we assert that the risk of unblinding is minimal due to the anesthesia condition of patients and the absence of postoperative care providers during the interventions. Although we utilized standard measures such as pain scores, total analgesic consumption, and time to first rescue analgesic, we acknowledge the growing emphasis on patient comfort and satisfaction, suggesting the incorporation of the Quality of Recovery (QoR-40) scale. Our findings indicated that patients receiving the erector spinae plane block had significantly lower postoperative pain scores compared to those receiving the rectus sheath block, surpassing the minimal clinically important difference (MCID) threshold at most time points post-surgery. Although the reduction in morphine consumption was statistically significant, it did not meet the MCID threshold due to the employed rescue analgesic protocol and the limitations of the study. We also addressed the critique regarding our sample size calculation, stating that estimates were derived from prior research, which aligns with standard methodological practices. However, we acknowledge that the study may have been underpowered to identify differences in postoperative nausea and vomiting outcomes.

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