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The External Oblique Intercostal Block: Anatomic Evaluation and Case Series
Hesham Elsharkawy1,2, Sree Kolli3, Loran Mounir Soliman3
1Department of Anesthesiology, Pain and Healing Center, MetroHealth, Case Western Reserve University, Cleveland, Ohio, USA.
Pain Medicine (Malden, Mass.)
|October 9, 2021
Summary
The external oblique intercostal (EOI) block provides effective upper abdominal wall analgesia. This technique successfully targets intercostal nerves T7-T10, offering pain relief in clinical settings.
Area of Science:
- Anesthesiology
- Regional Anesthesia
- Surgical Pain Management
Background:
- Upper abdominal wall analgesia is crucial for surgical procedures.
- Current techniques may have limitations in achieving comprehensive coverage.
- A novel approach is needed to improve pain management in this region.
Purpose of the Study:
- To introduce and evaluate the external oblique intercostal (EOI) block for upper midline and lateral abdominal wall analgesia.
- To assess the anatomical feasibility and clinical efficacy of the EOI block.
Main Methods:
- A combined cadaveric and retrospective cohort study design.
- Ultrasound-guided bilateral EOI blocks performed on unembalmed cadavers with dye injection.
- Retrospective analysis of 22 patients receiving single-injection or continuous EOI blocks.
Main Results:
- Cadaveric study demonstrated consistent dye spread to intercostal nerves T7-T10.
- Patients experienced consistent dermatomal sensory blockade from T6-T10 at the anterior axillary line.
- Midline blockade extended from T6-T9.
Conclusions:
- The external oblique intercostal (EOI) block is a viable technique for upper abdominal wall analgesia.
- Anatomical dissection confirmed nerve targeting, correlating with clinical sensory blockade.
- The EOI block offers a promising option for multimodal pain management in various clinical scenarios.
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