RT Journal Article
SR Electronic
T1 EP074 Enhancing analgesia for a kocher incision: incorporating external oblique intercostal block in multimodal analgesia – a case series
JF Regional Anesthesia & Pain Medicine
JO Reg Anesth Pain Med
FD BMJ Publishing Group Ltd
SP A79
OP A80
DO 10.1136/rapm-2023-ESRA.136
VO 48
IS Suppl 1
A1 Amaral, Sara
A1 Medeiros, Heitor
A1 Lombardi, Rafael
A1 Bandeira, Marcelo
A1 Silva, Wallace Andrino da
A1 Pawa, Amit
YR 2023
UL http://rapm.bmj.com/content/48/Suppl_1/A79.abstract
AB Background and Aims The External Oblique Intercostal block (EOIB) provides analgesia to the upper midline and upper lateral abdominal wall. This study assesses the efficacy of this block in patients undergoing cholecystectomy with a right subcostal incision.Methods We describe fourteen elective open cholecystectomy cases where a right external oblique intercostal plane block (EOIB) was performed with 30mL of 0.33% ropivacaine after the induction of general anesthesia. During surgery, all patients received 3µg/kg of Fentanyl and an additional 50µg bolus as needed, 30mg/kg Metamizole, and 100mg Ketoprofen. For postoperative nausea and vomiting (PONV) prophylaxis, Ondansetron 0.15mg/kg and Dexamethasone 0.15mg/kg were administered. Postoperative analgesia was maintained with 1g IV Metamizole 8/8h. Opioid consumption, complications, and patient satisfaction with analgesia were recorded within the first 24h. Demographics and intraoperative profiles were collected (table 1). Consent was obtained from all patients.View this table:Abstract EP074 Table 1 Demographic profile and intra and postoperative characteristicsView this table:Abstract EP074 Table 2 Pain scores using VAS within the first 24 hours postoperativelyAbstract EP074 Figure 1 External oblique intercostal plane block illustration and ultrasound imageResults Upon PACU admission, over 75% of patients had a VAS of less than 3, and the highest pain score was observed at 12 and 24 hours postoperatively, which corresponds to the block’s analgesia duration (table 2). The postoperative opioid consumption was relatively low overall with only 4 patients requiring one time use of Tramadol 100mg IV. Patient satisfaction with analgesia was high, as indicated by 70% of patients providing a satisfaction score of 10/10. No cases of PONV or block-related complications were observed.Conclusions Our findings suggest that EOIB reduces pain scores and opioid consumption for Kocher surgeries and is an effective part of a multimodal analgesia strategy