External Oblique Intercostal Plane Block With or Without Rectus Sheath Block After Laparoscopic Cholecystectomy

NCT07788911 | Completed

• 1 other identifier: EOIPB-RSB-OBS-2025-01
• Study Type: observational
• Target: 104
• Locations: 1 country
• Sites: 1

Brief Summary

This prospective observational cohort study compared postoperative pain outcomes in patients undergoing laparoscopic cholecystectomy who received bilateral external oblique intercostal plane block (EOIPB) alone or bilateral EOIPB combined with bilateral rectus sheath block (RSB). The block technique was selected by the attending anesthesiologist as part of routine clinical practice and was not assigned by the researchers. Postoperative pain intensity was assessed using a 0-10 visual analog scale at 1, 2, 4, 8, 12, and 24 hours after surgery. Intraoperative remifentanil consumption, postoperative rescue analgesic consumption, hemodynamic measurements, postoperative nausea and vomiting, other analgesic-related adverse effects, and patient satisfaction were also evaluated during the first 24 postoperative hours.

Conditions

Postoperative Pain

Keywords

Laparoscopic Cholecystectomy; External Oblique Intercostal Plane Block; Rectus Sheath Block; Regional Anesthesia; Postoperative Analgesia

Outcome Measures

Primary Outcomes (1)

• Postoperative Pain Intensity Assessed by Visual Analog Scale

  Postoperative pain intensity was assessed using a 0-10 visual analog scale, where 0 indicates no pain and 10 indicates the worst imaginable pain. Scores were compared between the two cohorts.

  At 1, 2, 4, 8, 12, and 24 hours after surgery

Secondary Outcomes (3)

• Total Intraoperative Remifentanil Consumption

  From induction of anesthesia to the end of surgery

• Total Postoperative Opioid Consumption

  During the first 24 hours after surgery

• Patient Satisfaction With Postoperative Analgesia

  At 24 hours after surgery

Study Arms (2)

Bilateral EOIPB Cohort

Participants who received bilateral external oblique intercostal plane block as part of routine clinical care. The block technique was selected and performed by the attending anesthesiologist independently of the study investigators. No rectus sheath block was performed in this cohort.

Procedure: Bilateral External Oblique Intercostal Plane Block

Bilateral EOIPB Combined With Bilateral RSB Cohort

Participants who received bilateral external oblique intercostal plane block combined with bilateral rectus sheath block as part of routine clinical care. Both block procedures were selected and performed by the attending anesthesiologist independently of the study investigators.

Procedure: Bilateral External Oblique Intercostal Plane Block; Procedure: Bilateral Rectus Sheath Block

Interventions

Bilateral External Oblique Intercostal Plane Block PROCEDURE

Under ultrasound guidance, bilateral external oblique intercostal plane block was performed using a total of 40 mL of 0.25% bupivacaine solution, with 20 mL administered on each side. The final solution was prepared by mixing 20 mL of 0.5% bupivacaine with 20 mL of normal saline, corresponding to a total bupivacaine dose of 100 mg. The procedure was selected and performed by the attending anesthesiologist as part of routine clinical practice, independently of the study investigators.

Also known as: EOIPB

Bilateral EOIPB Cohort; Bilateral EOIPB Combined With Bilateral RSB Cohort

Bilateral Rectus Sheath Block PROCEDURE

Under ultrasound guidance, bilateral rectus sheath block was performed using a total of 20 mL of 0.25% bupivacaine solution, with 10 mL administered on each side. The final solution was prepared by mixing 10 mL of 0.5% bupivacaine with 10 mL of normal saline, corresponding to a total bupivacaine dose of 50 mg. The procedure was selected and performed by the attending anesthesiologist as part of routine clinical practice, independently of the study investigators.

Also known as: RSB

Bilateral EOIPB Combined With Bilateral RSB Cohort

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Adult patients aged 18 to 70 years with American Society of Anesthesiologists physical status I to III who underwent laparoscopic cholecystectomy were included. Participants were observed in two cohorts according to the regional block technique selected and performed by the attending anesthesiologist as part of routine clinical care.

You may qualify if:

• Adults aged 18 to 70 years
• American Society of Anesthesiologists physical status I to III
• Scheduled to undergo laparoscopic cholecystectomy
• Received bilateral EOIPB alone or bilateral EOIPB combined with bilateral RSB as part of routine clinical care
• Provided written informed consent to participate

You may not qualify if:

• Contraindication to regional block procedures, including coagulopathy, anticoagulant use, or local infection at the needle insertion site
• Known severe cardiovascular, renal, or hepatic disease
• Life-threatening hematological disease
• Neurological disease or psychiatric disorder
• Known allergy to the medications used in the study or to amide-type local anesthetics
• History of chronic pain
• History of narcotic substance or alcohol dependence
• Body mass index of 35 kg/m² or greater
• Pregnancy
• Refusal to participate

Sponsors & Collaborators

• Bakirkoy Dr. Sadi Konuk Research and Training Hospital: lead

Study Sites (1)

Bakirkoy Dr. Sadi Konuk Training and Research Hospital

Istanbul, 34147, Turkey (Türkiye)

Location

Related Publications (3)

• Hamilton DL, Manickam BP, Wilson MAJ, Abdel Meguid E. External oblique fascial plane block. Reg Anesth Pain Med. 2019 Jan 11:rapm-2018-100256. doi: 10.1136/rapm-2018-100256. Online ahead of print. No abstract available.

  PMID: 30635518 BACKGROUND

• Elsharkawy H, Kolli S, Soliman LM, Seif J, Drake RL, Mariano ER, El-Boghdadly K. The External Oblique Intercostal Block: Anatomic Evaluation and Case Series. Pain Med. 2021 Nov 26;22(11):2436-2442. doi: 10.1093/pm/pnab296.

  PMID: 34626112 BACKGROUND

• Kitamura N, Iida H, Maehira H, Mori H, Sada Y, Shimizu T, Kitagawa H, Tani M. Postoperative analgesic effect of ultrasound-guided rectus sheath block and local anesthetic infiltration after laparoscopic cholecystectomy: Results of a prospective randomized controlled trial. Asian J Endosc Surg. 2022 Jan;15(1):29-35. doi: 10.1111/ases.12957. Epub 2021 Jun 22.

  PMID: 34159732 BACKGROUND

MeSH Terms

Conditions

Pain, Postoperative

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 24, 2026
• First Posted: August 27, 2026
• Study Start: May 15, 2025
• Primary Completion: April 26, 2026
• Study Completion: April 26, 2026
• Last Updated: August 27, 2026

Record last verified: 2026-08

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)