External Oblique Intercostal Block vs Erector Spinae Plane Block for Postoperative Analgesia After Laparoscopic Cholecystectomy

NCT07377877 | Recruiting

• 1 other identifier: EOIBESP2026
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 2

Brief 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.

Conditions

External Oblique Intercostal Block; Erector Spina Plan Block; Pain Management

Keywords

External Oblique Intercostal Block; Erector Spinae Plane Block; Laparoscopic Cholecystectomy; Ultrasound-Guided Nerve Block

Outcome Measures

Primary Outcomes (1)

• 24-hour cumulative opioid consumption

  Total opioid consumption within the first 24 hours, including PCA-administered morphine and rescue analgesics converted to morphine milligram equivalents (MME).

  postoperative day 1

Secondary Outcomes (9)

• 12-hour cumulative opioid consumption

  postoperative 12th hour

• Postoperative pain scores (NRS at rest)

  postoperative day 1

• Postoperative pain scores (NRS during activity)

  postoperative day 1

• Patient-reported quality of recovery (QoR-15 score)

  postoperative day 1

• Postoperative nausea and vomiting incidence (PONV)

  Postoperative day 1

Study Arms (2)

Group EOIB

ACTIVE COMPARATOR

Patients allocated to the EOIB group will be transferred to the regional anesthesia area and monitored approximately 45 minutes before surgery. With the patient in the supine position, bilateral ultrasound-guided external oblique intercostal block (EOIB) will be performed. A total volume of 60 mL of 0.25% bupivacaine (30 mL per side) will be injected. General anesthesia will then be administered according to standard practice. In the postoperative period, additional analgesia will be provided using intravenous morphine patient-controlled analgesia (PCA).

Procedure: Ultrasound-Guided External Oblique Intercostal Block

Group ESPB

ACTIVE COMPARATOR

Patients allocated to the ESPB group will be transferred to the regional anesthesia area and monitored approximately 45 minutes before surgery. With the patient in the supine position, bilateral ultrasound-guided erector spinae plane block (ESPB) will be performed. A total volume of 60 mL of 0.25% bupivacaine (30 mL per side) will be injected. General anesthesia will then be administered according to standard practice. In the postoperative period, additional analgesia will be provided using intravenous morphine patient-controlled analgesia (PCA).

Procedure: Ultrasound-Guided Erector Spinae Plane Block

Interventions

Ultrasound-Guided External Oblique Intercostal Block PROCEDURE

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.

Group EOIB

Ultrasound-Guided Erector Spinae Plane Block PROCEDURE

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.

Group ESPB

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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

You may not qualify if:

• 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

Sponsors & Collaborators

• Karabuk University: lead

Study Sites (2)

Karabuk Training and Research Hospital, Department of Anesthesiology and Reanimation

Karabük, 78200, Turkey (Türkiye)

RECRUITING

Department of Anesthesiology and Reanimation, Samsun City Hospital

Samsun, 55200, Turkey (Türkiye)

RECRUITING

MeSH Terms

Conditions

Agnosia

Condition Hierarchy (Ancestors)

Perceptual Disorders; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Elif Sarikaya Ozel, M.D.

  Karabuk Training and Research Hospital, Department of Anesthesiology

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Elif Sarikaya Ozel, M.D.

CONTACT

+905462361453; elsarikay2@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: Block randomization lists will be generated using Microsoft Office 365 Excel (Microsoft, Redmond, WA, USA), and patients will be randomly assigned to one of the two study groups in a 1:1 ratio. According to the randomization result, group allocation will be placed in sealed opaque envelopes. Forty-five minutes before block performance, an independent nurse who is not involved in the study will deliver the envelope containing group assignment to the anesthesiologist performing the regional block. Patients, surgeons, ward nurses, and all personnel involved in postoperative data collection and outcome assessment will remain blinded to group allocation. Investigators responsible for outcome evaluation and statistical analysis will also be blinded to the randomization results. To ensure block quality and standardization, all regional blocks will be performed by a single experienced anesthesiologist who has performed each block technique at least 30 times. For masking purposes, this anesth
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator- M.D. Karabuk Training and Research Hospital, Department of Anesthesiology

Model Details: Participants will be randomly assigned in a 1:1 ratio to receive either external oblique intercostal block or erector spinae plane block, and outcomes will be compared between two parallel intervention groups.

Study Record Dates

• First Submitted: January 21, 2026
• First Posted: January 30, 2026
• Study Start: January 1, 2026
• Primary Completion: April 1, 2026
• Study Completion: April 15, 2026
• Last Updated: January 30, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

TU (2)