Perioperative analgesic effect and safety of ultrasound-guided external oblique intercostal block and oblique subcostal transversus abdominis plane block in patients receiving laparoscopic radical gastrectomy

Fang Tang; Zichang Yang; Zhiyi Liu; Min Dai; Ruilin Hu; Lianghui Huang; Qi Yu

doi:10.62347/TAWR9849

Perioperative analgesic effect and safety of ultrasound-guided external oblique intercostal block and oblique subcostal transversus abdominis plane block in patients receiving laparoscopic radical gastrectomy

Am J Transl Res. 2024 Nov 15;16(11):7126-7135. doi: 10.62347/TAWR9849. eCollection 2024.

Authors

Fang Tang¹, Zichang Yang², Zhiyi Liu³, Min Dai⁴, Ruilin Hu⁴, Lianghui Huang⁴, Qi Yu³

Affiliations

¹ Department of Anesthesiology, Medical Center of Anesthesiology and Pain, The First Affiliated Hospital of Nanchang University Nanchang 330006, Jiangxi, China.
² The First Clinical Medical College of Nanchang University Nanchang 330000, Jiangxi, China.
³ Department of Anesthesiology and Operative Medicine, Medical Center of Anesthesiology and Pain, The First Affiliated Hospital of Nanchang University Nanchang 330006, Jiangxi, China.
⁴ Department of General Surgery, The First Affiliated Hospital of Nanchang University Nanchang 330052, Jiangxi, China.

Abstract

Objective: To compare the perioperative analgesic effect and safety of ultrasound-guided external oblique intercostal (EOI) block versus oblique subcostal transversus abdominis plane (OSTAP) block in patients receiving laparoscopic radical gastrectomy.

Methods: A prospective study was conducted on sixty patients who underwent laparoscopic radical gastrectomy for gastric cancer at the First Affiliated Hospital of Nanchang University from January 2022 to September 2022. Patients were divided into the EOI block group and the OSTAP block group according to the random number table, with 30 patients in each group. Outcome measures were Visual Analog Scale scores assessed at rest and during activity at different time points, the number of effective analgesic pump compressions at 24 h post-surgery, the number of rescue analgesia at 24 h post-surgery, fentanyl consumption at 24 h post-surgery, and the occurrence of postoperative block-related complications.

Results: The postoperative pain scores, measured at rest and during coughing, decreased in both groups. The pain scores at 12 h post-surgery were lower than those at 1 h and 6 h post-surgery in both groups (all P<0.05), and the pain scores at 24 h and 48 h post-surgery were also lower than those at 1 h, 6 h, and 12 h post-surgery (all P<0.05). The EOI block group exhibited reduced pain scores at 12 h and 24 h post-surgery compared to the OSTAP block group (all P<0.01). Additionally, the EOI group demonstrated a decreased number of effective analgesic pump compressions and a lower incidence of patients requiring rescue analgesia at 24 h post-surgery (all P<0.05), along with reduced cumulative fentanyl consumption at 6-12 h and 12-24 h post-surgery (P<0.05). There was no significant difference in the incidence of postoperative block-related complications between the two groups (P>0.05).

Conclusion: Ultrasound-guided EOI block offers superior postoperative analgesic effect compared to OSTAP block in patients undergoing laparoscopic radical gastrectomy, without increasing the risk of complications postoperatively (Clinical registration number: ChiCTR2300070668).

Keywords: External oblique intercostal block; complication; laparoscopic radical gastrectomy; oblique subcostal transversus abdominis plane block; postoperation pain.