External Oblique Intercostal Block vs Erector Spinae Plane Block for Postoperative Analgesia After Laparoscopic Cholecystectomy
Ultrasound-Guided External Oblique Intercostal Block Versus Erector Spinae Plane Block for Postoperative Analgesia After Laparoscopic Cholecystectomy: A Randomized Controlled Study
Karabuk University
60 participants
Jan 1, 2026
INTERVENTIONAL
Conditions
Summary
This randomized controlled study aims to compare the effects of the external oblique intercostal block (EOIB) and the erector spinae plane block (ESPB) on postoperative analgesia in adult patients undergoing elective laparoscopic cholecystectomy. Both EOIB and ESPB are ultrasound-guided regional anesthesia techniques currently used in clinical practice to improve postoperative pain control as part of multimodal analgesia strategies. Laparoscopic cholecystectomy is a common minimally invasive surgical procedure; however, patients may still experience postoperative pain that can increase opioid consumption and delay recovery. Identifying the most effective regional anesthesia technique may improve postoperative analgesia and patient recovery. In this study, eligible patients will be randomly assigned to receive either bilateral EOIB or bilateral ESPB in addition to standardized general anesthesia and postoperative patient-controlled analgesia. Postoperative pain scores, opioid consumption, quality of recovery, postoperative nausea and vomiting, and block-related complications will be evaluated during the first 24 hours after surgery. The study aims to provide comparative clinical evidence regarding the analgesic effectiveness of these two regional anesthesia techniques.
Eligibility
Inclusion Criteria5
- Age between 18 and 80 years
- Scheduled to undergo elective laparoscopic cholecystectomy
- Classified as American Society of Anesthesiologists (ASA) physical status I-III
- Ability to understand and operate a patient-controlled analgesia (PCA) device
- Provision of written informed consent
Exclusion Criteria9
- History of chronic opioid use for more than four weeks prior to surgery
- Presence of pre-existing chronic pain conditions, such as migraine or fibromyalgia
- History of alcohol or substance abuse
- Known hypersensitivity or allergy to local anesthetics or opioids
- Presence of severe organ dysfunction, including clinically significant hepatic or renal disease
- Any contraindication to regional anesthesia
- Severe psychiatric disorders impairing patient cooperation or the ability to reliably assess pain (e.g., psychosis, dementia)
- Pregnancy or breastfeeding
- Presence of hematological disorders
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Interventions
Bilateral ultrasound-guided external oblique intercostal block performed approximately 45 minutes before surgery. A total of 60 mL of 0.25% bupivacaine (30 mL per side) is injected into the fascial plane deep to the external oblique muscle.
Bilateral ultrasound-guided erector spinae plane block performed approximately 45 minutes before surgery. A total of 60 mL of 0.25% bupivacaine (30 mL per side) is injected into the fascial plane deep to the erector spinae muscle at the thoracic level under ultrasound guidance.
Locations(2)
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NCT07377877