Laparoscopic cholecystectomy is a common surgical procedure that can cause significant postoperative pain, particularly originating from trocar insertion sites. Regional anesthesia techniques are frequently used as part of multimodal analgesia to improve patient comfort.
This randomized controlled trial aims to evaluate the efficacy of adding a recto-intercostal fascial plane block (RIFPB) to an external oblique intercostal plane block (EOIPB). Patients scheduled for elective laparoscopic cholecystectomy will be randomly assigned to receive either an EOIPB alone or a combination of EOIPB and RIFPB. The primary objective is to determine if the combined block approach provides superior postoperative analgesia, evaluated by compared to the EOIPB alone.
Aged between 18 and 75 years
American Society of Anesthesiologists (ASA) physical status I, II, or III
Patients scheduled for elective laparoscopic cholecystectomy
Known allergy to local anesthetics
Infection at the procedure/injection site
Severe coagulopathy or use of anticoagulants
Chronic opioid consumption or history of neuropathic pain
Parallel
Group EOIPB (External Oblique Intercostal Plane Block)
Procedure/SurgeryPatients will undergo bilateral EOIPB procedure using 20 ml of 0.20% bupivacaine on each side under ultrasound guidance.
Group EOIPB + RIFPB (Combined Blocks)
Procedure/SurgeryPatients will undergo bilateral EOIPB and RIFPB procedures under ultrasound guidance using 20 ml of 0.20% bupivacaine for the EOIPB block and 15 ml of 0.20% bupivacaine for the RIFPB on each side.
Postoperative Pain Intensity
Pain will be assessed using a visual analog scale from 0 mm (no pain) to 100 mm (worst pain) at rest. Pain assessment at rest will be made at 4 hours after surgery.
Postoperative Pain Intensity
Pain will be assessed using a visual analog scale from 0 mm (no pain) to 100 mm (worst pain) at rest. Pain assessment at rest will be made at 1, 8, 12, and 24 hours after surgery.
Postoperative Pain Intensity
ain will be assessed using a visual analog scale from 0 mm (no pain) to 100 mm (worst pain) while coughing. Pain assessment will be made at 1, 4, 8, 12, and 24 hours after surgery.
Total Postoperative Opioid Consumption
The total amount of opioid consumed by the patient will be recorded.
Severity of Postoperative Nausea and Vomiting (PONV)
The severity of postoperative nausea will be assessed using an 11-point numerical rating scale (NRS), ranging from 0 to 10, where 0 indicates no nausea and 10 indicates the worst possible nausea. Vomiting will be recorded as the number of vomiting episodes. Nausea severity will be assessed at 1, 4, 8, 12, and 24 hours after surgery. Higher NRS scores indicate greater nausea severity.
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