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Background <p>The aim of this study was to investigate the effects of external oblique intercostal nerve block (EOIB) on early postoperative pain and recovery in patients undergoing J-shaped incision surgery in the upper abdomen.</p> Methods <p>Patients aged 18–85 years, classified as ASA I-III, undergoing elective open upper abdominal J-shaped incision surgery under general anesthesia were included in this study. Patients were randomized into two groups: the external oblique intercostal nerve block group (Group E ) and the control group (Group C ). Following induction of general anesthesia, Group E received 30&#xa0;ml of 0.375% ropivacaine and 4&#xa0;mg dexamethasone for ultrasound-guided EOIB on the surgical side, while Group C received no nerve block. Postoperatively, both groups utilized fentanyl patient-controlled intravenous analgesia. The primary outcome of the study was the 24-hour fentanyl consumption recorded for both groups. Patients with a Numeric Rating Scale (NRS) score &gt; 4 were administered 40&#xa0;mg parecoxib sodium as rescue analgesia.</p> Results <p>Postoperative fentanyl consumption at 24&#xa0;h was significantly lower in Group E compared to Group C (832.92 ± 66.42&#xa0;μg vs. 1021.25 ± 76.63&#xa0;μg, <i>p</i> = 0.001). Group E demonstrated lower NRS scores at rest and during movement at 0, 2, 4, 12, and 24&#xa0;h postoperatively compared to Group C, but similar scores at 48&#xa0;h. The time to first ambulation (49.92 ± 4.21&#xa0;h vs. 58.38 ± 2.95&#xa0;h, <i>p</i> = 0.001) and time to first flatus (59.79 ± 2.49&#xa0;h vs. 67.83 ± 2.48&#xa0;h, <i>p</i> = 0.001) were both shorter in Group E than in Group C, with higher Quality of Recovery-15 (QoR-15) scores in Group E (108.00 ± 3.80 vs. 97.00 ± 5.13, <i>p</i> = 0.001).</p> Conclusion <p>EOIB significantly enhances postoperative analgesia in patients undergoing upper abdominal J-shaped incision surgery, reducing opioid consumption and analgesic requirements, and improving the quality of recovery. It may be considered as part of a multimodal analgesic regimen following upper abdominal surgery.</p> Trial registration <p>This study was registered in the Chinese Clinical Trial Testing Center (ID: ChiCTR2300076653, 10.13.2023).</p>

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The impact of external oblique intercostal block on early postoperative pain and recovery in patients undergoing J-shaped incisions for upper abdominal surgery: a single-center prospective randomized controlled study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月5日

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  • Shuai Yi,
  • Xinlei Zhang,
  • Yuhong Song,
  • Xiaohui Wang,
  • Han Gao,
  • Zhao Yuan,
  • Mingjian Kong

摘要

Background

The aim of this study was to investigate the effects of external oblique intercostal nerve block (EOIB) on early postoperative pain and recovery in patients undergoing J-shaped incision surgery in the upper abdomen.

Methods

Patients aged 18–85 years, classified as ASA I-III, undergoing elective open upper abdominal J-shaped incision surgery under general anesthesia were included in this study. Patients were randomized into two groups: the external oblique intercostal nerve block group (Group E ) and the control group (Group C ). Following induction of general anesthesia, Group E received 30 ml of 0.375% ropivacaine and 4 mg dexamethasone for ultrasound-guided EOIB on the surgical side, while Group C received no nerve block. Postoperatively, both groups utilized fentanyl patient-controlled intravenous analgesia. The primary outcome of the study was the 24-hour fentanyl consumption recorded for both groups. Patients with a Numeric Rating Scale (NRS) score > 4 were administered 40 mg parecoxib sodium as rescue analgesia.

Results

Postoperative fentanyl consumption at 24 h was significantly lower in Group E compared to Group C (832.92 ± 66.42 μg vs. 1021.25 ± 76.63 μg, p = 0.001). Group E demonstrated lower NRS scores at rest and during movement at 0, 2, 4, 12, and 24 h postoperatively compared to Group C, but similar scores at 48 h. The time to first ambulation (49.92 ± 4.21 h vs. 58.38 ± 2.95 h, p = 0.001) and time to first flatus (59.79 ± 2.49 h vs. 67.83 ± 2.48 h, p = 0.001) were both shorter in Group E than in Group C, with higher Quality of Recovery-15 (QoR-15) scores in Group E (108.00 ± 3.80 vs. 97.00 ± 5.13, p = 0.001).

Conclusion

EOIB significantly enhances postoperative analgesia in patients undergoing upper abdominal J-shaped incision surgery, reducing opioid consumption and analgesic requirements, and improving the quality of recovery. It may be considered as part of a multimodal analgesic regimen following upper abdominal surgery.

Trial registration

This study was registered in the Chinese Clinical Trial Testing Center (ID: ChiCTR2300076653, 10.13.2023).