Ultrasound-Guided External Oblique Intercostal Fascial Plane Block for Postoperative Analgesia | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Volume 100, Issue 1, July 2025, Page 3960-3965 PDF (732.82 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2025.450683 | ||||
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| Abstract | ||||
| Background: After abdominal wall surgery, improved recovery largely depends on effective postoperative analgesia. Currently, there is no clinical data to support the clinical efficacy of ultrasound-guided external oblique intercostal fascial plane block (EOIPB), a novel regional anesthesia technique that provides anterior and lateral abdominal wall analgesia. Objectives: This study aimed to evaluate the analgesic efficacy and safety of ultrasound-guided EOIPB in patients undergoing paraumbilical hernioplasty. Patients and Methods: This prospective single-arm study included 30 adult patients (ASA physical status I–II) scheduled for elective paraumbilical hernioplasty under general anesthesia. All patients received bilateral ultrasound-guided EOIPB with 20 mL of local anesthetic on each side (10mL 0.5% bupivacaine, 5mL 2% lidocaine, and 5 mL of normal saline). Postoperative analgesia consisted of paracetamol and ketorolac, with morphine administered if the Numeric Rating Scale (NRS score) exceeded 3. The primary outcomes included 24-hour morphine consumption; secondary outcomes were serial NRS pain scores at rest and during coughing, hemodynamic parameters, and the incidence of postoperative nausea and vomiting (PONV). Results: Patients maintained low pain scores at rest and during coughing with significant improvement over time. The mean cumulative morphine requirement was 10.3 ± 4.0 mg in the first 24 hours, while intraoperative fentanyl consumption averaged 48.0±20.6 µg. Hemodynamic parameters demonstrated significant but clinically acceptable variability, with transient reductions in heart rate and mean arterial pressure observed during the early postoperative period. PONV occurred in 5 patients (16.7%), all of whom were managed successfully with antiemetics. Conclusion: Ultrasound-guided EOIPB is a safe and effective technique for postoperative analgesia following paraumbilical hernioplasty. It provides sustained pain relief, reduces opioid consumption, maintains hemodynamic stability, and is associated with a low incidence of complications. | ||||
| Keywords | ||||
| External Oblique Intercostal Fascial Plane Block; Paraumbilical hernioplasty; Postoperative analgesia; Opioid consumption | ||||
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