Recto-intercostal fascial plane block for postoperative analgesia in laparoscopic cholecystectomy

The recto-intercostal fascial plane block is a novel regional anaesthetic technique proposed for cardiac and upper abdominal surgery, with limited evidence for its use in laparoscopic cholecystectomy. We report a series of seven patients undergoing elective laparoscopic cholecystectomy under general anaesthesia, one of whom required a xipho-umbilical incision for common bile duct exploration. All patients received a recto-intercostal fascial plane block prior to surgical incision. Postoperative analgesia included paracetamol 1000 mg for all patients, with one patient additionally receiving diclofenac 75 mg. At 1, 3, 6, 12 and 24 h postoperatively, pain scores remained low (numerical rating scale 0-2 at rest and 2-3 on movement), no rescue opioids were required and all patients had an uncomplicated recovery with early discharge. These cases illustrate the feasibility of incorporating recto-intercostal fascial plane block into multimodal analgesia after laparoscopic cholecystectomy.