P330 Serratus intercostal block as an analgesic rescue strategy in emergency laparotomy

<h3></h3> <b>Application for ESRA Abstract Prizes:</b> <h3>Background and Aims</h3> Regional anesthesia is increasingly used in emergency surgeries to minimize the need for intraoperative and postoperative opioids, particularly in patients with poor general health. This can be achieved through techniques such as neuraxial anesthesia or peripheral nerve blocks. <h3>Methods</h3> Based on the results of our study Serratus intercostal interfascial plane block in supraumbilical surgery: a prospective randomized comparison (DOI: 10.23736/S0375-9393.20.14882-X), we have also decided to use the serratus intercostal plane block technique in patients undergoing emergency laparotomy, without applying local anesthetics to the surgical wound, and evaluate the outcomes. <h3>Results</h3> The primary focus will be on comparing postoperative epidural analgesia with bilateral serratus intercostal block. Key outcomes will include pain intensity measured using the Visual Analog Scale (VAS) in the immediate postoperative period and at 24 hours, time to first ambulation, and the need for intravenous opioid rescue analgesia. <h3>Conclusions</h3> The lower intercostal nerves innervate the abdominal wall and peritoneum, including the rectus abdominis muscles and the skin of the anterior abdominal wall. The serratus intercostal plane block provides effective coverage for the laparotomy area without causing motor impairment in the lower limbs, a side effect commonly associated with epidural analgesia. Additionally, it avoids opioid-related adverse effects such as nausea, vomiting, delayed gastrointestinal and urinary function, and confusion, especially in elderly patients or those with a history of cognitive impairment.