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Abstract
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Background and Aims Laparoscopic cholecystectomy is a surgical procedure for the removal of the gallbladder. Despite being minimally invasive, it can still result in postoperative pain. We present three cases of laparoscopic cholecystectomy surgeries in which External Oblique Intercostal Block (EOIB), Rectus Sheath Block (RSB) and Quadratus Lumborum Block (QLB) techniques were employed.
Methods Case 1. Female, 38 years old, ASA 2. We performed bilateral EOIB with bupivacaine 0.25% 20 ml and RSB with bupivacaine 0.25% 15 ml on each side preoperatively after general anesthesia. Case 2. Male, 68 years old, ASA 2. We performed bilateral anterior QLB with ropivacaine 0.2% 30ml on each side pre operatively after general anesthesia. Case 3. Male, 19 years old, ASA 2, undergone laparoscopy cholecystectomy. We did bilateral EOIB + RSB after general anesthesia, with bupivacaine 0.25% 20ml for EOIB and bupivacaine 0.25% 15 ml for RSB on each side. Following complications arising from bile leakage, necessitating a shift to laparotomy and an extended surgical procedure lasting approximately for eleven hours - resulted in elevated heart rate thereby requiring supplementation of bilateral QLB with bupivacaine 0.25% 20 ml on each side for the rescue analgesia after the completion of surgery.
Results Intraoperatively, patients required minimal or no opioid injections and remained hemodynamically stable compared to those without regional anesthesia. After surgery, the patients smoothly emerged from general anesthesia and maintained satisfactory numerical rating scores of <4 for 24 hours with no need for postoperative opioids
Conclusions Regional anesthesia contribute to enhanced pain control, reduced opioid consumption, and improved perioperative outcomes.
Anterior Quadratus Lumborum Block
External Oblique Intercostal Block
Anterior Quadratus Lumborum Block