Application of unilateral rhomboid intercostal and subserratus plane block for analgesia after laparoscopic cholecystectomy: a quasi-experimental study

Abstract

Background: Interfascial plane block applications can be used for postoperative pain after laparoscopic surgery. We aimed to investigate the effect of ultrasound-guided unilateral rhomboid intercostal and subserratus plane (RISS) block after laparoscopic cholecystectomy operations on the amount of analgesic use.Methods: 50 patients underwent laparoscopic cholecystectomy were included in the quasiexperimental study. Patients meeting the criteria were analyzed in two groups as experimental group (RISS block with 20 ml %0.25 bupivacaine+intravenous patient-controlled analgesia (IV-PCA) tramadol ; n = 25) and group Control (IV-PCA tramadol; n = 25).The primary outcome was the total amount of tramadol used over 24 hours.Secondary outcomes included the side effects, additional analgesic use and postoperative pain (during rest and activity) was at the 2nd, 6th, 12th, and 24th hours using the NRS scores . Results:Postoperative tramadol consumption at the 24 hours was significantly lower in the Group RISS than the Group Control (p<0.001). The resting NRS scores at the 2nd and 6th hours were statistically significantly low in the Grup RISS. The NRS scores during movement in Grup RISS were significantly low at the postoperative 2nd, 6th, and 12th hours.There was no statistically significant difference in the rate of side effects and additional analgesic use between the groups (p>0.05). Conclusions:In conclusion, unilateral RISS block is an effective method for pain management after laparoscopic cholecystectomy and can be used as a part of multimodal analgesia.

Bilateral external oblique intercostal plane block (EOIPB) in patients undergoing laparoscopic cholecystectomy

“…The incision sites at the trocar entry points for LC are associated with T6 to T10 dermatomes. 24 The EOIPB was preferred in the present study as it creates analgesia in the lateral and anterior abdominal walls between the T6 -T10 dermatomes, and is therefore aimed at the somatic component caused by the incisions at the entry sites of the trocars. Following the definition of EOIPB, some case series with application of EOIPB for upper abdominal surgery were published.…”