This study aims to compare the analgesic efficacy, duration of analgesia, and overall opioid consumption between the external oblique intercostal plane (EOIP) block and subcostal transversus abdominis plane (TAP) block in patients undergoing laparoscopic sleeve gastrectomy.
Age from 18 to 65 years.
Both genders.
American Society of Anesthesiologists (ASA) class I or II
Body mass index (BMI) between 30-50 kg/m².
Patient refusal.
Allergy to local anesthetics.
Coagulation disorders or anticoagulant therapy.
Local infection or scar at the injection site.
Parallel
External oblique intercostal plane block
Other interventionPatients will receive an ultrasound-guided bilateral external oblique intercostal plane (EOIP) block using 20 mL of 0.25% bupivacaine in each side after induction of anesthesia and prior to surgical incision.
Subcostal transversus abdominis plane block
Other interventionPatients will receive a bilateral subcostal transversus abdominis plane (TAP) block using 20 mL of 0.25% bupivacaine in each side, under ultrasound guidance and identical conditions.
Total morphine consumption
Patient-controlled analgesia (PCA) using intravenous morphine (1 mg bolus, 10-minute lockout) will be available for rescue analgesia when visual analogue score ( VAS ) \> 3.
Time to first rescue analgesia
Time to first rescue analgesia will be recorded from the end of surgery till first dose of morphine administrated.
Degree of pain
Each patient will be instructed about postoperative pain assessment with the visual analogue score (VAS). VAS (0 represents "no pain" while 10 represents "the worst pain imaginable"). VAS will be recorded at 0, 2, 6, 12, and 24 hours postoperatively (at rest and cough).
Heart rate
Heart rate will be recorded intraoperatively and postoperatively
Mean arterial blood pressure
Mean arterial blood pressure will be recorded intraoperatively and postoperatively
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