Comparison of Oblique Subcostal Transversus Abdominis Plane Block and External Oblique Intercostal Plane Block for Postoperative Pain Management in Laparoscopic Cholecystectomy

Ertas G., Cakmak H. S., AVCI M. A., Yildirim K. U., AKGÜN C., Tulgar S.

Journal of the College of Physicians and Surgeons Pakistan, cilt.35, sa.12, ss.1504-1510, 2025 (SCI-Expanded, Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 35 Sayı: 12
  • Basım Tarihi: 2025
  • Doi Numarası: 10.29271/jcpsp.2025.12.1504
  • Dergi Adı: Journal of the College of Physicians and Surgeons Pakistan
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.1504-1510
  • Anahtar Kelimeler: External oblique intercostal plane block, Laparoscopic cholecystectomy, Oblique subcostal TAP block, Postoperative pain management, Regional anaesthesia
  • Samsun Üniversitesi Adresli: Evet

Özet

Objective: To compare the efficacy and safety of oblique subcostal transversus abdominis plane (OSTAP) block and external oblique intercostal plane (EOIP) block for postoperative pain management in patients undergoing laparoscopic cholecystectomy (LC). Study Design: A randomised controlled trial. Place and Duration of the Study: Department of General Surgery, Samsun University Training and Research Hospital, Samsun, Turkiye, between January and September 2024. Methodology: Eighty adult patients undergoing elective LC were randomly divided into two groups: OSTAP block (n = 40) and EOIP block (n = 40). Blocks were performed at the end of surgery. The primary outcome was cumulative opioid consumption. The secondary outcomes included pain intensity measured by Numerical Rating Scale (NRS), time to first analgesic request, quality of recovery (QoR-15 score), and incidence of postoperative nausea and vomiting. Statistical analysis included the t-test, Mann-Whitney U test, and Chi-square test, with Bonferroni correction applied for repeated NRS measurements. Results: Demographic characteristics and perioperative variables were comparable between the groups. The mean 24-hour tramadol consumption was similar in both groups (175 ± 98.79 mg vs. 184 ± 106.62 mg; p = 0.696). The pain scores were not significantly different at all measured time points (p >0.05). In addition, time to first analgesic request (p = 0.954) and QoR-15 scores (p = 0.269) were comparable. No major block-related complications were observed. Conclusion: Effective postoperative analgesia was achieved in both groups with similar opioid consumption and pain scores. However, the EOIP block may be considered as a technically easier and safer alternative for regional analgesia in LC. Further research is needed to determine the long-term benefits and optimum clinical applications of these blocks in laparoscopic surgery.