External oblique intercostal plane block as an alternative to subcostal TAP block for laparoscopic cholecystectomy: a prospective randomized study.

BACKGROUND: The external oblique intercostal plane (EOIP) block is a novel technique proposed for upper abdominal analgesia; however, its clinical efficacy remains unclear. This study compares EOIP and subcostal TAP (sTAP) blocks in laparoscopic cholecystectomy (LC), focusing on postoperative pain scores and opioid requirements. METHODS: Eighty patients were divided into two groups: EOIP block and subcostal TAP. Bilateral blocks were performed with 20 ml 0.375% bupivacaine in both groups after general anesthesia. Patients were evaluated in the PACU and postoperative periods. Visual analogue pain scores (VAS) and opioid consumption were measured. RESULTS: There was no statistical difference between VAS scores at rest and active movement at all measurement times (p > 0.05). Opioid consumption in the first 4 h was less in the sTAP group than in the EOIP group (p = 0.039) However, there was no statistical difference in opioid consumption at 24 h (p = 0.215). There was no statistical difference between the groups in terms of rescue analgesia, opioid and block-related complications (p > 0.05). CONCLUSIONS: Given its comparable efficacy to the subcostal TAP block in lessening opioid consumption and postoperative pain, the EOIP block represents a practical and effective adjunct to multimodal analgesia procedures in LC. TRIAL REGISTRATION NUMBER: NCT05632991 (registered at clinicaltrials, principal investigator: Ali Ahiskalioglu, registration date: November 21, 2022).