Nerve block techniques utilized in post-bariatric surgery: a narrative review

Pain relief following bariatric surgery (BS) can be difficult because many patients have obstructive sleep apnea and are more prone to breathing problems caused by excessive opioid use post-surgery. Using nerve blocks is an effective alternative since they enhance patient comfort and decrease the side effects of opioids. In our review, we comprehensively reviewed present methods to alleviate pain after BS including the transversus abdominis plane block (TAPB), the erector spinae plane block (ESPB), the quadratus lumborum block (QLB), the external oblique intercostal block (EOIB), and the rectus sheath block (RB), aiming to summarized the respective and relative advantages of each nerve block for post-BS analgesia. The review concluded that TAPB is the optimized post-BS nerve block for somatic pain and ESPB relieves somatic and visceral pain which can both be combined with RB. Anterior QLB relieves visceral pain and EOIB can be done without the interference of fat. This review also identified key points for future research to improve post-BS nerve blocks.