Ahmed Abdalwahab Mohammed Mansour Yahya Hammad Mohammed Ismael Doaa Abdelfattah

Keywords: ultrasound-guided analgesia, Pain, laparoscopic cholecystectomy, external oblique intercostal plane block, subcostal transversus abdominis plane block

Abstract

Background & objective: The superiority of external oblique intercostal plane (EOIP) block over oblique subcostal transversus abdominis plane (OSTAP) block for intra and postoperative analgesia in laparoscopic cholecystectomy has not been established. Therefore, this study compared the efficacy of the analgesic effect between EOIP block and OSTAP block in patients undergoing laparoscopic cholecystectomy.

Methodology: This randomized controlled clinical trial was conducted on adult patients who underwent elective laparoscopic cholecystectomy from 2023 to 2024. Patients were randomly allocated into two groups at a 1:1 ratio. Group A (n = 20) included patients who received ultrasound-guided bilateral EOIP block, and Group B (n = 20) included patients who received ultrasound-guided OSTAP block.

Results: Group A had a longer time to rescue analgesia (7.05 ± 0.76 vs. 4.95 ± 0.83 min, P < 0.001), and consumed a significantly lower total dose of nalbuphine (0.1 ± 0.02 vs. 0.12 ± 0.02 mg/kg; P = 0.025). The pain score was lower in Group A, particularly at 4 and 6 hours postoperatively (P < 0.001).

Conclusions: Ultrasound-guided bilateral EOIP block provides superior analgesia than OSTAP with a longer time to rescue analgesia, lower opioid consumption, and improved early postoperative pain scores in patients undergoing laparoscopic cholecystectomy.

Abbreviations: EOIP: external oblique intercostal plane, IQR: interquartile ranges. LP: Laparoscopic cholecystectomy, OSTAP: oblique subcostal transversus abdominis plane, VAS: visual analog scale,

Keywords: external oblique intercostal plane block; laparoscopic cholecystectomy; Pain; subcostal transversus abdominis plane block; ultrasound-guided analgesia

Citation: Abdalwahab A, Mansour M, Hammad YM, Ismael MO, Abdelfattah DF. Bilateral ultrasound-guided external oblique intercostal plane block versus bilateral subcostal transversus abdominis plane block in laparoscopic cholecystectomy: a randomized controlled trial. Anaesth. pain intensive care 2025;29(4):363-70. DOI: 10.35975/apic.v29i4.2821

Received: March 02, 2025; Revised: April 20, 2025; Accepted: May 01, 2025