OP54 Analgesic efficacy of serratus intercostal block versus epidural analgesia in open abdominal eventration: a randomised study

<h3>Background and Aims</h3> Abdominal wall repair, including eventroplasty, is a frequent surgery in our operating theatres. These surgeries are associated with severe postoperative pain. The aim of the study is to evaluate whether serratus-intercostal block (SIPB) is equal or superior to epidural analgesia in terms of pain control and quality of postoperative recovery. <h3>Methods</h3> Following the approval of the ethical committee (no. 22-EO132 in September 2022) and registration (Trial registration number: NCT06014749), this prospective low-level intervention study of non-inferiority was initiated. The calculated sample size was determined to be n = 70, ensuring that a two-sided test with α = 0.05 would have 95% power to detect no difference in the proportion of patients. The NRS 3 was considered to be the difference. The inclusion criteria were abdominal eventration repair, over 18 years of age, ASA I-III. The two groups consisted of: SIPB (patients who received serratus-intercostal plane block) and epidural analgesia, both techniques associated with general anaesthesia. In the postoperative period, pain was assessed with specific forms using the NRS numeric rating scale and the quality of recovery with the modified QoR-15 scale. <h3>Results</h3> The statistics results show a no intraoperative fentanyl consumption difference between cohorts SIPB/Epi (243/214 µg) (p 0,37) and a postoperative morphine consumption of SIPB 0.36 mg + 0.88 and epidural 1.79 mg + 1.04 (p 0,01). In dynamic pain control NRS 6 (SIPB 0.7; epidural 3.2) (p 0,008), NRS12 (SIPB 2.2; epidural 4.4) (p 0,001), NRS24 (SIPB 2; epidural 4.3) (p &lt; 0,001). The adverse effects showed were (epidural: 5 catheters moved, 4 urine retention). Figure 1. The quality of recovery was better in SIPB group. Figure 2. <h3>Conclusions</h3> In summary, both techniques have shown adequate postoperative pain control, although SIPB has shown a superiority in the first 24 h, presenting this block as an alternative to epidural analgesia in eventroplasty.