External oblique intercostal plane block versus subcostal transversus abdominis plane block for pain control in supraumbilical surgeries: a randomised controlled clinical trial

\r\nBackground\r\nThe external oblique intercostal block (EOIB) was designed to provide upper median and lateral abdominal wall analgesia. Its efficacy was mainly explored in case reports and retrospective studies. Our study aimed to prospectively assess EOIB efficacy in open supraumbilical procedur...

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Veröffentlicht in:Southern African journal of anaesthesia and analgesia 2024-09, Vol.30 (4), p.112-117
Hauptverfasser: Amin, SR, Khedr, AN, Elhadad, MA
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container_title Southern African journal of anaesthesia and analgesia
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creator Amin, SR
Khedr, AN
Elhadad, MA
description \r\nBackground\r\nThe external oblique intercostal block (EOIB) was designed to provide upper median and lateral abdominal wall analgesia. Its efficacy was mainly explored in case reports and retrospective studies. Our study aimed to prospectively assess EOIB efficacy in open supraumbilical procedures compared to subcostal transversus abdominis plane (TAP) blockade for pain control in the first 24 postoperative hours.\r\n\r\nMethods\r\nA total of 63 adult patients scheduled for variable upper abdominal procedures involving supraumbilical incision were allocated randomly to three groups (21 each). After induction of general anaesthesia, patients received either EOIB (group E), subcostal TAP block (group T), or no block (group C). The primary study outcome was morphine consumption in the first 24 postoperative hours. Secondary outcomes included intraoperative fentanyl supplements, haemodynamic variables, time to first rescue analgesia, postoperative Visual Analogue Scale (VAS) scores, the occurrence of complications, and patient satisfaction.\r\n\r\nResults\r\nThe 24-hour postoperative morphine consumption and time to first rescue analgesia were significantly lower and longer, respectively, in the EOIB and subcostal TAP groups compared to the control group (p
doi_str_mv 10.36303/SAJAA.3134
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Its efficacy was mainly explored in case reports and retrospective studies. Our study aimed to prospectively assess EOIB efficacy in open supraumbilical procedures compared to subcostal transversus abdominis plane (TAP) blockade for pain control in the first 24 postoperative hours.\r\n\r\nMethods\r\nA total of 63 adult patients scheduled for variable upper abdominal procedures involving supraumbilical incision were allocated randomly to three groups (21 each). After induction of general anaesthesia, patients received either EOIB (group E), subcostal TAP block (group T), or no block (group C). The primary study outcome was morphine consumption in the first 24 postoperative hours. Secondary outcomes included intraoperative fentanyl supplements, haemodynamic variables, time to first rescue analgesia, postoperative Visual Analogue Scale (VAS) scores, the occurrence of complications, and patient satisfaction.\r\n\r\nResults\r\nThe 24-hour postoperative morphine consumption and time to first rescue analgesia were significantly lower and longer, respectively, in the EOIB and subcostal TAP groups compared to the control group (p&lt;0.001) without significant differences between the intervention groups. VAS scores at rest and during cough were significantly higher in the control group than in the intervention groups. However, EOIB achieved less intraoperative fentanyl requirements than subcostal TAP (p = 0.04), with better haemodynamic stability and longer control of pain than the control group.\r\n\r\nConclusion\r\nThe EOIB is as effective as subcostal TAP in delivering optimal analgesia and reducing perioperative opioid requirements. Considering the intraoperative advantages of EOIB in terms of lower fentanyl needs and better haemodynamic control, the EOIB is an attractive substitute for postoperative pain reduction following open upper abdominal surgeries.</description><identifier>ISSN: 2220-1181</identifier><identifier>EISSN: 2220-1173</identifier><identifier>DOI: 10.36303/SAJAA.3134</identifier><language>eng</language><publisher>Medpharm Publications</publisher><subject>abdominal incisions ; Analgesia ; external oblique ; Nerve blocks ; Postoperative ; TAP block</subject><ispartof>Southern African journal of anaesthesia and analgesia, 2024-09, Vol.30 (4), p.112-117</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c185t-cfbbbda5bbf5a513101f1cf6e6913f1bcf5efae5a1c9eb3ee039fe6710ec56313</cites><orcidid>0000-0002-3428-1985 ; 0000-0002-1122-6692 ; 0000-0001-8115-2775</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906,39223</link.rule.ids></links><search><creatorcontrib>Amin, SR</creatorcontrib><creatorcontrib>Khedr, AN</creatorcontrib><creatorcontrib>Elhadad, MA</creatorcontrib><title>External oblique intercostal plane block versus subcostal transversus abdominis plane block for pain control in supraumbilical surgeries: a randomised controlled clinical trial</title><title>Southern African journal of anaesthesia and analgesia</title><description>\r\nBackground\r\nThe external oblique intercostal block (EOIB) was designed to provide upper median and lateral abdominal wall analgesia. Its efficacy was mainly explored in case reports and retrospective studies. Our study aimed to prospectively assess EOIB efficacy in open supraumbilical procedures compared to subcostal transversus abdominis plane (TAP) blockade for pain control in the first 24 postoperative hours.\r\n\r\nMethods\r\nA total of 63 adult patients scheduled for variable upper abdominal procedures involving supraumbilical incision were allocated randomly to three groups (21 each). After induction of general anaesthesia, patients received either EOIB (group E), subcostal TAP block (group T), or no block (group C). The primary study outcome was morphine consumption in the first 24 postoperative hours. Secondary outcomes included intraoperative fentanyl supplements, haemodynamic variables, time to first rescue analgesia, postoperative Visual Analogue Scale (VAS) scores, the occurrence of complications, and patient satisfaction.\r\n\r\nResults\r\nThe 24-hour postoperative morphine consumption and time to first rescue analgesia were significantly lower and longer, respectively, in the EOIB and subcostal TAP groups compared to the control group (p&lt;0.001) without significant differences between the intervention groups. VAS scores at rest and during cough were significantly higher in the control group than in the intervention groups. However, EOIB achieved less intraoperative fentanyl requirements than subcostal TAP (p = 0.04), with better haemodynamic stability and longer control of pain than the control group.\r\n\r\nConclusion\r\nThe EOIB is as effective as subcostal TAP in delivering optimal analgesia and reducing perioperative opioid requirements. Considering the intraoperative advantages of EOIB in terms of lower fentanyl needs and better haemodynamic control, the EOIB is an attractive substitute for postoperative pain reduction following open upper abdominal surgeries.</description><subject>abdominal incisions</subject><subject>Analgesia</subject><subject>external oblique</subject><subject>Nerve blocks</subject><subject>Postoperative</subject><subject>TAP block</subject><issn>2220-1181</issn><issn>2220-1173</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>JRA</sourceid><recordid>eNpVkEFLAzEQhRdRUKon_0Du0ppsmtV6K0WrUvCgnsMkO7GpaXbN7Ir-K3-iaa2Cpwxv3vuGvKI4FXwkK8nl-eP0fjodSSHHe8VRWZZ8KMSF3P-bL8VhcUK04pxnT6nK8VHxdf3RYYoQWGOCf-uR-ZgF21CXtTZARGZCY1_ZOybqiVFvdssuQaSdCqZu1j56-hdxTWIt-MhsE7vUhMzO-TZBvzY-eJsh1KcXTB7pigHLwA2GsP5NhM0YMthuD3oIx8WBg0B4snsHxfPN9dPsdrh4mN_NpouhFZeqG1pnjKlBGeMUKCEFF05YV2E1EdIJY51CB6hA2AkaicjlxGF1IThaVeUOB8XZD9emhiih023ya0ifWnC97Vtv-9abvrN7_uMmMD5ipwmw7Y1edl1LelkHvcx_C6g3O8FVyTWurF5jTbAC0O-S6zjWMJbfH1mUkQ</recordid><startdate>20240901</startdate><enddate>20240901</enddate><creator>Amin, SR</creator><creator>Khedr, AN</creator><creator>Elhadad, MA</creator><general>Medpharm Publications</general><scope>AEIZH</scope><scope>JRA</scope><scope>AAYXX</scope><scope>CITATION</scope><orcidid>https://orcid.org/0000-0002-3428-1985</orcidid><orcidid>https://orcid.org/0000-0002-1122-6692</orcidid><orcidid>https://orcid.org/0000-0001-8115-2775</orcidid></search><sort><creationdate>20240901</creationdate><title>External oblique intercostal plane block versus subcostal transversus abdominis plane block for pain control in supraumbilical surgeries: a randomised controlled clinical trial</title><author>Amin, SR ; Khedr, AN ; Elhadad, MA</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c185t-cfbbbda5bbf5a513101f1cf6e6913f1bcf5efae5a1c9eb3ee039fe6710ec56313</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>abdominal incisions</topic><topic>Analgesia</topic><topic>external oblique</topic><topic>Nerve blocks</topic><topic>Postoperative</topic><topic>TAP block</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Amin, SR</creatorcontrib><creatorcontrib>Khedr, AN</creatorcontrib><creatorcontrib>Elhadad, MA</creatorcontrib><collection>Sabinet:Open Access</collection><collection>Sabinet African Journals Open Access Collection</collection><collection>CrossRef</collection><jtitle>Southern African journal of anaesthesia and analgesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Amin, SR</au><au>Khedr, AN</au><au>Elhadad, MA</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>External oblique intercostal plane block versus subcostal transversus abdominis plane block for pain control in supraumbilical surgeries: a randomised controlled clinical trial</atitle><jtitle>Southern African journal of anaesthesia and analgesia</jtitle><date>2024-09-01</date><risdate>2024</risdate><volume>30</volume><issue>4</issue><spage>112</spage><epage>117</epage><pages>112-117</pages><issn>2220-1181</issn><eissn>2220-1173</eissn><abstract>\r\nBackground\r\nThe external oblique intercostal block (EOIB) was designed to provide upper median and lateral abdominal wall analgesia. Its efficacy was mainly explored in case reports and retrospective studies. Our study aimed to prospectively assess EOIB efficacy in open supraumbilical procedures compared to subcostal transversus abdominis plane (TAP) blockade for pain control in the first 24 postoperative hours.\r\n\r\nMethods\r\nA total of 63 adult patients scheduled for variable upper abdominal procedures involving supraumbilical incision were allocated randomly to three groups (21 each). After induction of general anaesthesia, patients received either EOIB (group E), subcostal TAP block (group T), or no block (group C). The primary study outcome was morphine consumption in the first 24 postoperative hours. Secondary outcomes included intraoperative fentanyl supplements, haemodynamic variables, time to first rescue analgesia, postoperative Visual Analogue Scale (VAS) scores, the occurrence of complications, and patient satisfaction.\r\n\r\nResults\r\nThe 24-hour postoperative morphine consumption and time to first rescue analgesia were significantly lower and longer, respectively, in the EOIB and subcostal TAP groups compared to the control group (p&lt;0.001) without significant differences between the intervention groups. VAS scores at rest and during cough were significantly higher in the control group than in the intervention groups. However, EOIB achieved less intraoperative fentanyl requirements than subcostal TAP (p = 0.04), with better haemodynamic stability and longer control of pain than the control group.\r\n\r\nConclusion\r\nThe EOIB is as effective as subcostal TAP in delivering optimal analgesia and reducing perioperative opioid requirements. Considering the intraoperative advantages of EOIB in terms of lower fentanyl needs and better haemodynamic control, the EOIB is an attractive substitute for postoperative pain reduction following open upper abdominal surgeries.</abstract><pub>Medpharm Publications</pub><doi>10.36303/SAJAA.3134</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-3428-1985</orcidid><orcidid>https://orcid.org/0000-0002-1122-6692</orcidid><orcidid>https://orcid.org/0000-0001-8115-2775</orcidid><oa>free_for_read</oa></addata></record>
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2220-1173
language eng
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source Sabinet African Journals Open Access Collection
subjects abdominal incisions
Analgesia
external oblique
Nerve blocks
Postoperative
TAP block
title External oblique intercostal plane block versus subcostal transversus abdominis plane block for pain control in supraumbilical surgeries: a randomised controlled clinical trial
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