RIPB Versus EOIPB for Pain Control After Laparoscopic Cholecystectomy
Comparison of the Effects of Recto-Intercostal Plane Block and External Oblique Intercostal Plane Block on Postoperative Analgesia in Patients Undergoing Elective Laparoscopic Cholecystectomy
Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital
60 participants
Apr 25, 2026
OBSERVATIONAL
Conditions
Summary
This prospective observational study aims to compare the effects of bilateral ultrasound-guided recto-intercostal plane block(RIPB) and bilateral ultrasound-guided external oblique intercostal plane block(EOIPB) on postoperative analgesia in patients undergoing elective laparoscopic cholecystectomy under general anesthesia. Both blocks are performed after anesthesia induction as part of routine preemptive multimodal analgesia practice. Patients who receive bilateral recto-intercostal plane block will be included in the RIPB group, and patients who receive bilateral external oblique intercostal plane block will be included in the EOIPB group. The primary outcome is cumulative intravenous tramadol consumption via patient-controlled analgesia during the first 24 postoperative hours. Secondary outcomes include postoperative pain scores at rest and during activity, rescue analgesic requirement, postoperative nausea and vomiting, time to mobilization, length of hospital stay, quality of recovery assessed using the Quality of Recovery-15 questionnaire, and block-related complications.
Eligibility
Inclusion Criteria4
- Age between 18 and 75 years
- American Society of Anesthesiologists (ASA) physical status I-III
- Scheduled for elective laparoscopic cholecystectomy under general anesthesia
- Written informed consent obtained
Exclusion Criteria13
- Refusal to participate
- Inability to understand the study protocol or provide informed consent
- Known allergy to local anesthetics, tramadol, paracetamol, dexketoprofen, or other study drugs
- Chronic opioid or steroid use
- Psychiatric or cognitive disorder preventing reliable pain assessment
- Inability to use patient-controlled analgesia
- Pregnancy or breastfeeding
- Coagulopathy
- Infection at the block site
- Difficult or prolonged intubation requiring three or more attempts
- Conversion to open surgery
- Surgery lasting longer than 120 minutes
- Intraoperative or postoperative complications requiring deviation from the standard analgesia protocol
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Interventions
Bilateral recto-intercostal plane block was performed under ultrasound guidance after anesthesia induction. Local anesthetic was injected into the fascial plane between the rectus abdominis muscle and the intercostal structures as part of routine preemptive analgesia.
Bilateral external oblique intercostal plane block was performed under ultrasound guidance after anesthesia induction. Local anesthetic was injected into the fascial plane between the external oblique muscle and the intercostal muscles as part of routine preemptive analgesia.
Locations(1)
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NCT07607262