A double blind randomised comparative study of external oblique intercostal plane block versus subcostal transversus abdominis plane block for upper abdominal laparoscopic surgeries

Aims and Objectives: The aim of this study was to compare the postoperative analgesic efficacy of the external oblique intercostal (EOI) block with the subcostal transversus abdominis plane (TAP) block. The primary objective was to compare the numerical rating scale (NRS) scores postoperatively. The secondary objectives were to compare the total duration of analgesia and total analgesic consumption in the first postoperative 24 hours. Material and Methods: A double blind, randomised study was conducted in a tertiary care academic hospital. Seventy-six patients of either gender, aged between 20 and 70 years, belonging to American Society of Anesthesiologists (ASA) physical status classes I and II, posted for elective laparoscopic surgeries were included. The patients were induced as per the routine general anaesthesia protocol. Post-surgery, prior to extubation, an ultrasound-guided EOI block or subcostal TAP block was performed as per group distribution. The patient was then extubated and shifted to the recovery room. The postoperative NRS score, total duration of analgesia, and total analgesic consumption in the first 24 hours were noted. The postoperative paracetamol requirement and complications were noted. Results: The NRS score was significantly low at 2,4,6,8,10,12,16,18,24 hours postoperatively in patients who received EOM as compared to those who received subcostal TAP block (p value <0.05). The PCM requirement was also low in EOI block patients, but the p-value was not significant (p-value = 0.29). Conclusion: EOI block is an effective and preferred block as compared to the subcostal TAP block, as it provides better postoperative analgesia.