EOIB for Pain After Laparoscopic Cholecystectomy

Shiyou Wei

Status: Not yet enrolling

Conditions: Postoperative Pain; Laparoscopic Cholecystectomy

Treatments: Other: External oblique intercostal block (EOIB); Other: Standard care without regional block

Study type: Interventional

Funder types: Other

Identifiers

NCT07332546

20250322

Details and patient eligibility

About

This prospective, randomized, controlled, assessor-blinded trial will evaluate whether bilateral ultrasound-guided external oblique intercostal block (EOIB) reduces postoperative opioid consumption and improves pain control after laparoscopic cholecystectomy, compared with no block.

Full description

Laparoscopic cholecystectomy is a common procedure, yet postoperative pain remains clinically significant despite routine multimodal analgesia, and opioid use may cause adverse effects. External oblique intercostal block (EOIB) is a newer ultrasound-guided fascial plane block that may provide effective analgesia for upper abdominal surgery.

This study is a prospective, randomized, controlled, assessor-blinded trial in patients undergoing elective laparoscopic cholecystectomy. A total of 56 participants will be randomized 1:1 to receive either bilateral ultrasound-guided EOIB or no regional block. EOIB will be performed bilaterally under ultrasound guidance at the level of the 6th rib in the 6th-7th intercostal space using an in-plane technique, with 15 mL of study local anesthetic mixture injected per side. Postoperatively, all participants will receive standardized multimodal analgesia, including intravenous patient-controlled analgesia (PCA) with butorphanol and non-opioid analgesics per protocol.

The primary outcome is total opioid consumption during the first 24 hours after surgery. Secondary outcomes include postoperative pain scores (VRS) at prespecified time points, quality of recovery (QoR-15) at 24 hours, opioid consumption from 24-48 hours, postoperative nausea and vomiting, intraoperative hemodynamic events, time to first flatus, and length of hospital stay. The trial aims to determine whether adding bilateral EOIB to standard analgesia can reduce opioid requirements and improve recovery after laparoscopic cholecystectomy.

Note for your protocol alignment: your document contains a potential inconsistency about "no other opioids within 72 hours" versus recording "rescue opioid" use; you may want to standardize this wording before final submission.

Enrollment: 56 estimated patients

Sex: All

Ages: 18 to 85 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Aged 18-85 years, regardless of gender
• American Society of Anesthesiologists (ASA) physical status classification I-III
• Scheduled for elective laparoscopic cholecystectomy
• Ability to use the intravenous patient-controlled analgesia (IV PCA) system

Exclusion criteria

• Hepatic disease (e.g., liver enzyme levels ≥ 2× the upper limit of normal)
• Renal disease (e.g., serum creatinine levels ≥ 2× the upper limit of normal)
• Allergy or known hypersensitivity to local anesthetics
• Females who are pregnant or lactating
• Conversion to open surgery
• Coagulopathy or current use of anticoagulant medications
• Opioid use for more than 2 weeks in the past 6 months

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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56 participants in 2 patient groups

EOIB Group

Experimental group

Description:

Participants receive bilateral ultrasound-guided external oblique intercostal block (EOIB) (15 mL of the study local anesthetic mixture per side) in addition to standard general anesthesia and standardized postoperative analgesia (IV PCA butorphanol ).

Treatment:

Other: External oblique intercostal block (EOIB)

Control Group

Sham Comparator group

Description:

Participants do not receive any regional block. They receive standard general anesthesia and standardized postoperative analgesia only (IV PCA butorphanol).

Treatment:

Other: Standard care without regional block