Comparison of Analgesic Method in Laparoscopic Gastrectomy Using External Oblique Intercostal Block Versus Wound...

Area of Science:

• Anesthesiology
• Regional Anesthesia
• Surgical Pain Management

Background:

• External oblique intercostal block (EOIB) is recognized for pain relief in specific dermatomes.
• Limited comparative data exists between EOIB and conventional regional anesthesia techniques.
• This study addresses the efficacy of EOIB versus wound infiltration (WI) for laparoscopic gastrectomy pain.

Purpose of the Study:

• To compare the analgesic effectiveness of EOIB against WI in patients undergoing laparoscopic gastrectomy.
• To evaluate postoperative pain, recovery quality, and opioid consumption between the two techniques.

Main Methods:

• A randomized controlled trial involving 32 patients (ASA I-II) scheduled for laparoscopic gastrectomy.
• Patients were randomized to receive either EOIB or WI using 40 mL of 0.25% levobupivacaine.
• Primary outcome: Numerical Rating Scale (NRS) pain score at 12 hours postoperatively.

Main Results:

• No significant difference in NRS pain scores at 12 hours postoperatively was observed between the EOIB and WI groups (at rest and during movement).
• Secondary outcomes, including pain at other time points, quality of recovery, and fentanyl consumption, also showed no significant differences.
• Levobupivacaine peak plasma concentration after EOIB was reached at 45 minutes.

Conclusions:

• EOIB and WI provide comparable postoperative analgesia 12 hours after laparoscopic gastrectomy.
• The study did not find a significant advantage of EOIB over WI for the evaluated pain and recovery parameters.