Original Research Paper

Comparison Of Analgesic Efficacy Of External Oblique Intercostal Block With Erector Spinae Plane Block For Patients Undergoing Laparoscopic Cholecystectomy Surgery: Is There A Need To Go Deep?- A Pilot Study

Abstract :

Introduction: External oblique intercostal block (EOI) is a nascent fascial plane block recommended for upper abdominal surgery. There are very few studies comparing its analgesic efficacy. We compare the analgesic efficacy of this new block with erector spinae plane block (ESP) in patients undergoing laparoscopic cholecystectomy.Methods: A total of 30 patients undergoing laparoscopic cholecystectomy were considered for this prospective, randomized, single-blinded pilot study. Patients were divided randomly into two groups, group I (EOI block, n=15) & group II (ESP block, n=15). After administration of general anaesthesia, ultrasound guided blocks were given bilaterally using inj. 0.125% bupivacaine 50ml with inj. dexamethasone 4mg (25ml/side), high frequency linear transducer and 23G spinal needle. In Group I, block was performed at level of 6th rib between anterior-axillary and mid-clavicular line using in-plane approach. In Group II, block was administered at level of 8th rib using in-plane approach. Inj. fentanyl 0.5mcg/kg i.v. was administered as a rescue analgesic for intra-operative increase in HR & BP >25% from baseline and post-operative visual analogue scale score (VAS) > 4. Post-operative VAS scores for first 24 hours, intra-operative and post-operative rescue analgesics requirement, time to perform block and complications were compared between two groups.Results: There was no significant difference in post-operative first 24 hours VAS scores (p- 0.740, independent t test). Time to perform block was significantly different between two groups (Group I-12.8 +/- 1.64 mins vs Group II- 19.8 +/- 1.48 mins, p< 0.001, independent t test). No intra-operative and post-operative rescue analgesic requirements and no complications occurred in both the groups.Conclusion: EOI block provides similar analgesia but is faster to perform as compared to ESP block in patients undergoing laparoscopic cholecystectomy. There is no need to go deep in such cases.

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