Efficacy of ultrasound-guided recto-intercostal fascial plane block for postoperative analgesia in laparoscopic cholecystectomy: a randomized controlled trial

Abstract Background The recto-intercostal fascial plane block (RIFPB) is a novel interfascial plane block technique that targets the anterior and lateral cutaneous branches of the T6–T9 thoracoabdominal nerves. The purpose of this study was to assess RIFPB’s analgesic effectiveness in managing postoperative pain in patients having laparoscopic cholecystectomy (LC). Methods Patients scheduled for elective LC under general anesthesia who were between the ages of 18 and 65 and had ASA physical status I–II were included. Patients were divided into two groups at random: the control group (n = 38) and the RIFPB group (n = 39). While the control group received normal multimodal postoperative analgesia, the RIFPB group underwent bilateral RIFPB. The primary outcome was the need for rescue analgesia. Secondary outcomes included postoperative pain scores, and the incidence of adverse effects. Results When comparing the RIFPB group to the control group, the incidence of rescue analgesia was considerably lower (17.9 vs. 55.3%, p = 0.001), and total rescue analgesic (tramadol) consumption was reduced [0 (0–0) mg vs. 40 (0–50) mg, p = 0.001]. At 1, 3, 6, and 12 postoperative hours, the RIFPB group had significantly decreased pain scores (p < 0.05). The incidence of postoperative nausea, vomiting and itching was lower in the RIFPB group. Conclusions RIFPB provided effective postoperative pain control and reduced rescue analgesic requirements compared with standard analgesic management. Research registration number: NCT06768593.