Ultrasound-guided external oblique intercostal plane block versus subcostal transversus abdominis plane block for postoperative analgesia in living liver donors: A prospective randomized trial

IF 5.1 2区医学 Q1 ANESTHESIOLOGY

Journal of Clinical Anesthesia Pub Date : 2025-08-19 DOI:10.1016/j.jclinane.2025.111971

Taylan Sahin , Ali Sait Kavakli , Eryigit Eren , Alaaddin Aydin , Nese Kutluturk Sahin , Mehmet Tokac , Ayhan Dinckan

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Abstract

Introduction

Pain relief provided by the transversus abdominis plane (TAP) block in individuals who have undergone living liver donation during the postoperative period has been demonstrated in previous studies. The external oblique intercostal plane (EOI) block is a recently introduced technique designed to provide analgesia for the anterolateral region of the upper abdominal wall.

This study aims to evaluate and compare the efficacy of the external oblique intercostal plane (EOI) block and the subcostal TAP block in individuals who have undergone living liver donation.

Methods

Patients were randomly assigned to one of two groups: EOI block group and subcostal TAP block group. In both groups, bilateral blocks were performed using a total of 40 ml of 0.25 % bupivacaine at the end of surgery and prior to extubation. Postoperatively, all patients were connected to an intravenous patient-controlled analgesia (PCA) device containing morphine. The primary outcome of the study was intravenous morphine consumption during the first 24 h postoperatively.

Results

The median [interquartile range] morphine consumption at 24 h postoperatively was similar between EOI block and subcostal TAP block groups (23.5 [19.5 to 27.5] vs 26 [[24], [25], [26], [27], [28]], respectively). There were no significant differences in terms of numerical rating scale (NRS) scores at rest and during movement at 2, 6, 12 and 24 h. No block-related complications were observed in any patients.

Conclusion

The results of the study showed that there were no statistically significant differences in 24-h morphine consumption or pain scores at rest and during movement between the subcostal TAP and EOI block groups in living liver donors undergoing right hepatectomy. Either technique may be preferred depending on the clinician's experience and institutional practice.

Trial registration.

Clinicaltrials.gov identifier: NCT05890079

Abstract Image

查看原文本刊更多论文

超声引导下外斜肋间平面阻滞与肋下横腹平面阻滞对活体肝供者术后镇痛的影响：一项前瞻性随机试验

在以往的研究中，腹横面（TAP）阻滞对术后活体肝捐献患者的疼痛缓解作用已得到证实。外斜肋间平面（EOI）阻滞是最近引进的一种技术，旨在为上腹壁前外侧区域提供镇痛。本研究旨在评估和比较外斜肋间平面（EOI）阻滞和肋下TAP阻滞在活体肝捐献患者中的疗效。方法将患者随机分为两组：EOI阻滞组和肋下TAP阻滞组。在两组中，在手术结束和拔管前，使用共40 ml 0.25%布比卡因进行双侧阻滞。术后，所有患者均使用含吗啡的静脉自控镇痛（PCA）装置。研究的主要结果是术后24小时内静脉注射吗啡的用量。结果术后24 h吗啡用量中位数[四分位数范围]在EOI阻断组和肋下TAP阻断组之间相似（分别为23.5[19.5 ~ 27.5]和26[[24]，[25],[26],[27],[28]]）。2、6、12和24小时休息和运动时的数值评定量表（NRS）评分无显著差异。未观察到任何患者出现阻滞相关并发症。结论肋下TAP组和EOI阻断组右肝切除术活体肝供者24小时吗啡消耗、静息和运动时疼痛评分差异无统计学意义。根据临床医生的经验和机构实践，可以选择任何一种技术。试验注册。clinicaltrials .gov标识符：NCT05890079

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来源期刊

Journal of Clinical Anesthesia 医学-麻醉学

CiteScore

7.40

自引率

4.50%

发文量

346

审稿时长

23 days

期刊介绍： The Journal of Clinical Anesthesia (JCA) addresses all aspects of anesthesia practice, including anesthetic administration, pharmacokinetics, preoperative and postoperative considerations, coexisting disease and other complicating factors, cost issues, and similar concerns anesthesiologists contend with daily. Exceptionally high standards of presentation and accuracy are maintained. The core of the journal is original contributions on subjects relevant to clinical practice, and rigorously peer-reviewed. Highly respected international experts have joined together to form the Editorial Board, sharing their years of experience and clinical expertise. Specialized section editors cover the various subspecialties within the field. To keep your practical clinical skills current, the journal bridges the gap between the laboratory and the clinical practice of anesthesiology and critical care to clarify how new insights can improve daily practice.