Objectives: To measure tramadol intake in the first 24 hours post-surgery. In addition, pain scores and quality of recovery were evaluated as secondary outcomes.
Methods: A total of 80 adult patients scheduled for laparoscopic cholecystectomy were randomized into 2 groups (with and without external oblique intercostal plane block [EOIPB]). Control group of patients received standard multimodal analgesia, EOIPB was applied on each side to patients in EOIPB group in addition to multimodal analgesia. The primary outcome was to evaluate tramadol consumption at postoperative 24 hours. Secondary outcomes were evaluating the Numeric Rating Scale (NRS) scores, postoperative Quality of Recovery score (QoR-15), sedation score, the incidence of nausea and vomiting, and antiemetic consumption.
Results: In EOIPB group, median (Q1, Q3) tramadol consumption values for 24 hours (0 [0,50] mg) were found to be significantly lower than the control group (50 [50,100] mg) (median difference -50) (p<0.001). NRS values during rest and motion were lower in EOIPB group compared to the control group at all measurement points within 24 hours (p<0.05). The total QoR-15 scores were significantly higher in EOIPB group compared to the control group (p<0.001). No differences were detected in other secondary outcome parameters.
Conclusion: External oblique intercostal plane block resulted in less postoperative tramadol consumption. However, there were no minimal clinically important differences about postoperative opioid consumption. On the other hand, compared to multimodal analgesia addition of EOIPB improved overall QoR-15 scores at postoperative 24 hours.Clinical Trial Reg. No.: NCT05536557.
Keywords: external oblique intercostal plane block; laparoscopic cholecystectomy; nerve block; opioid analgesics; postoperative pain; ultrasonography.
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