Comparison of analgesic efficacy of ultrasound-guided external oblique intercostal plane block and subcostal transversus abdominis plane block in patients undergoing upper abdominal surgery: A randomised clinical study
Background and Aims: Upper abdominal surgeries are associated with severe postoperative pain. External oblique intercostal (EOI) block blocks both anterior and lateral cutaneous branches of intercostal nerves. We compared the postoperative analgesic efficacy of unilateral EOI block with conventional...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-11-01
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| Series: | Indian Journal of Anaesthesia |
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| Online Access: | https://journals.lww.com/10.4103/ija.ija_596_24 |
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| author | Shruti Shrey Chandni Sinha Abhyuday Kumar Ajeet Kumar Amarjeet Kumar Sreehari Nambiar |
| author_facet | Shruti Shrey Chandni Sinha Abhyuday Kumar Ajeet Kumar Amarjeet Kumar Sreehari Nambiar |
| author_sort | Shruti Shrey |
| collection | DOAJ |
| description | Background and Aims:
Upper abdominal surgeries are associated with severe postoperative pain. External oblique intercostal (EOI) block blocks both anterior and lateral cutaneous branches of intercostal nerves. We compared the postoperative analgesic efficacy of unilateral EOI block with conventional unilateral subcostal transversus abdominis plane (TAP) block.
Methods:
Fifty American Society of Anesthesiologists (ASA) I/II patients scheduled for upper abdominal surgery via subcostal incision were randomly assigned to receive either EOI block (Group E) or subcostal TAP block (Group T) with 25 mL of 0.2% ropivacaine. Postoperatively, these patients received intravenous (IV) fentanyl through a patient-controlled analgesia (PCA) pump with settings of demand-only mode. The primary outcome was the time to activation of PCA postoperatively. Secondary outcomes were 24-hour opioid consumption, pain scores (at 30 minutes and at 1, 2, 4, 6, 12, and 24 hours), patient satisfaction scores (48 hours), and block-related complications. Unpaired t-test and Mann-Whitney U test were used for analysis. A P value less than 0.05 was considered to be statistically significant.
Results:
Patients in Group E had an increased mean time of activation of PCA [610.28 [standard deviation (SD): 118.95)] minutes vs 409.68 (SD: 101.36) minutes] (P = 0.001). The 24-hour postoperative mean fentanyl consumption was 102.40 (SD: 25.70) μg in Group E versus 123.20 (SD: 34.38) μg in Group T (P = 0.019). Patients in Group E had better satisfaction scores (P < 0.001). Pain scores were better at 30 minutes and 6 hours.
Conclusion:
EOI block provides effective postoperative analgesia in upper abdominal surgeries as it prolongs the duration of PCA activation with a better patient satisfaction score. |
| format | Article |
| id | doaj-art-62769df0728d489987ba2e50fe0f22f3 |
| institution | Kabale University |
| issn | 0019-5049 0976-2817 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Anaesthesia |
| spelling | doaj-art-62769df0728d489987ba2e50fe0f22f32025-01-24T15:12:41ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50490976-28172024-11-01681196597010.4103/ija.ija_596_24Comparison of analgesic efficacy of ultrasound-guided external oblique intercostal plane block and subcostal transversus abdominis plane block in patients undergoing upper abdominal surgery: A randomised clinical studyShruti ShreyChandni SinhaAbhyuday KumarAjeet KumarAmarjeet KumarSreehari NambiarBackground and Aims: Upper abdominal surgeries are associated with severe postoperative pain. External oblique intercostal (EOI) block blocks both anterior and lateral cutaneous branches of intercostal nerves. We compared the postoperative analgesic efficacy of unilateral EOI block with conventional unilateral subcostal transversus abdominis plane (TAP) block. Methods: Fifty American Society of Anesthesiologists (ASA) I/II patients scheduled for upper abdominal surgery via subcostal incision were randomly assigned to receive either EOI block (Group E) or subcostal TAP block (Group T) with 25 mL of 0.2% ropivacaine. Postoperatively, these patients received intravenous (IV) fentanyl through a patient-controlled analgesia (PCA) pump with settings of demand-only mode. The primary outcome was the time to activation of PCA postoperatively. Secondary outcomes were 24-hour opioid consumption, pain scores (at 30 minutes and at 1, 2, 4, 6, 12, and 24 hours), patient satisfaction scores (48 hours), and block-related complications. Unpaired t-test and Mann-Whitney U test were used for analysis. A P value less than 0.05 was considered to be statistically significant. Results: Patients in Group E had an increased mean time of activation of PCA [610.28 [standard deviation (SD): 118.95)] minutes vs 409.68 (SD: 101.36) minutes] (P = 0.001). The 24-hour postoperative mean fentanyl consumption was 102.40 (SD: 25.70) μg in Group E versus 123.20 (SD: 34.38) μg in Group T (P = 0.019). Patients in Group E had better satisfaction scores (P < 0.001). Pain scores were better at 30 minutes and 6 hours. Conclusion: EOI block provides effective postoperative analgesia in upper abdominal surgeries as it prolongs the duration of PCA activation with a better patient satisfaction score.https://journals.lww.com/10.4103/ija.ija_596_24abdominal surgeryexternal oblique intercostal blockfentanylpatient-controlled analgesiapatient satisfactionpostoperative painsubcostal transversus abdominis plane block |
| spellingShingle | Shruti Shrey Chandni Sinha Abhyuday Kumar Ajeet Kumar Amarjeet Kumar Sreehari Nambiar Comparison of analgesic efficacy of ultrasound-guided external oblique intercostal plane block and subcostal transversus abdominis plane block in patients undergoing upper abdominal surgery: A randomised clinical study Indian Journal of Anaesthesia abdominal surgery external oblique intercostal block fentanyl patient-controlled analgesia patient satisfaction postoperative pain subcostal transversus abdominis plane block |
| title | Comparison of analgesic efficacy of ultrasound-guided external oblique intercostal plane block and subcostal transversus abdominis plane block in patients undergoing upper abdominal surgery: A randomised clinical study |
| title_full | Comparison of analgesic efficacy of ultrasound-guided external oblique intercostal plane block and subcostal transversus abdominis plane block in patients undergoing upper abdominal surgery: A randomised clinical study |
| title_fullStr | Comparison of analgesic efficacy of ultrasound-guided external oblique intercostal plane block and subcostal transversus abdominis plane block in patients undergoing upper abdominal surgery: A randomised clinical study |
| title_full_unstemmed | Comparison of analgesic efficacy of ultrasound-guided external oblique intercostal plane block and subcostal transversus abdominis plane block in patients undergoing upper abdominal surgery: A randomised clinical study |
| title_short | Comparison of analgesic efficacy of ultrasound-guided external oblique intercostal plane block and subcostal transversus abdominis plane block in patients undergoing upper abdominal surgery: A randomised clinical study |
| title_sort | comparison of analgesic efficacy of ultrasound guided external oblique intercostal plane block and subcostal transversus abdominis plane block in patients undergoing upper abdominal surgery a randomised clinical study |
| topic | abdominal surgery external oblique intercostal block fentanyl patient-controlled analgesia patient satisfaction postoperative pain subcostal transversus abdominis plane block |
| url | https://journals.lww.com/10.4103/ija.ija_596_24 |
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