Laparoscopic Gastrectomy Using External Oblique Intercostal Block Versus Wound Infiltration: A Trial Protocol

Area of Science:

• Regional anesthesia and pain management
• Surgical oncology and gastrointestinal surgery

Background:

• The external oblique intercostal block (EOIB) shows potential for analgesia in the T6-T10 dermatomes, relevant for laparoscopic gastrectomy.
• Current evidence on the efficacy of EOIB for postoperative pain following gastric surgery is lacking.

Purpose of the Study:

• To evaluate the analgesic effects of EOIB compared to wound infiltration (WI) in patients undergoing laparoscopic or robot-assisted gastrectomy.
• To generate evidence supporting the application of EOIB in minimally invasive gastric surgery.

Main Methods:

• A single-center, single-blind, randomized controlled trial comparing EOIB and WI.
• Patients will receive either EOIB or WI with levobupivacaine before skin closure after general anesthesia.
• Outcomes include Numeric Rating Scale (NRS) pain scores, fentanyl use, Quality of Recovery-15 (QoR-15) scores, and WHO Disability Assessment Schedule 2.0.

Main Results:

• Plasma concentrations and pharmacokinetics of levobupivacaine will be assessed post-EOIB.
• Pinprick test will evaluate sensory block extent.
• Primary outcome: NRS scores at 12 hours postoperatively.

Conclusions:

• The study aims to provide evidence for EOIB's utility in laparoscopic surgery.
• Levobupivacaine pharmacokinetics will be analyzed to infer the safety profile of EOIB.