Ultrasound-Guided Regional Blocks for Postoperative Analgesia After Laparoscopic Cholecystectomy

Medipol Health Group

Status: Not yet enrolling

Conditions: Plane Blocks; Laparoscopic Cholecystectomy; Pain Management; Acute Pain

Treatments: Other: Post-operative Pain Management; Procedure: Recto-Intercostal Fascial Plane Block; Procedure: Transversus- Abdominis Plane Block

Study type: Interventional

Funder types: Other

Identifiers

NCT07321639

Medipol Hospital 7

Details and patient eligibility

About

Ultrasound (US)-guided recto-intercostal fascial plane block (RIFPB) is a recently described abdominal wall block performed by injecting local anesthetic between the rectus abdominis muscle and the costal cartilage of the 7th rib. Due to the cranial attachment of the rectus muscle, this technique provides effective analgesia to the sternal, epigastric, and upper-mid abdominal regions, corresponding to the T6-T10/11 dermatomal levels. RIFPB may be used as an adjunct technique for thoracic procedures or as a standalone block for abdominal surgery.

Ultrasound-guided transversus abdominis plane block (TAPB) is performed by injecting local anesthetic into the fascial plane between the internal oblique and transversus abdominis muscles. TAPB provides sensory blockade of the anterolateral abdominal wall at the T6-L1 dermatomal levels and is widely used for postoperative analgesia following abdominal surgeries, including laparoscopic cholecystectomy.

This study aims to compare the effectiveness of US-guided RIFPB and TAPB on postoperative pain control after laparoscopic cholecystectomy.

Full description

Laparoscopic cholecystectomy is one of the most commonly performed abdominal surgical procedures. Postoperative pain after laparoscopic cholecystectomy is multifactorial and may result from trocar site incisions, visceral manipulation, peritoneal irritation, and diaphragmatic stimulation due to pneumoperitoneum. Various analgesic strategies, including systemic opioids, non-opioid analgesics, local anesthetic infiltration, and regional anesthesia techniques, are used to manage postoperative pain in these patients.

Ultrasound (US)-guided recto-intercostal fascial plane block (RIFPB) is a recently described regional anesthesia technique that provides analgesia to the sternal, epigastric, and upper-mid abdominal regions by targeting the fascial plane between the rectus abdominis muscle and the costal cartilage. RIFPB provides sensory blockade at the T6-T10/11 dermatomal levels and has been reported to be effective for postoperative analgesia in thoracic and upper abdominal procedures. Due to its anatomical spread and mechanism of action, RIFPB may offer effective analgesia following laparoscopic cholecystectomy.

Ultrasound-guided transversus abdominis plane block (TAPB) is a well-established regional anesthesia technique performed by injecting local anesthetic between the internal oblique and transversus abdominis muscles. TAPB provides analgesia to the anterolateral abdominal wall at the T6-L1 dermatomal levels and is commonly used for postoperative pain control after various abdominal surgeries, including laparoscopic cholecystectomy.

In this study, the investigators aim to compare the effectiveness of US-guided RIFPB and TAPB for postoperative pain management after laparoscopic cholecystectomy and to compare both techniques with a control group.

Enrollment: 90 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• ASA physical status I-II
• Scheduled for elective laparoscopic cholecystectomy

Exclusion criteria

• Known allergy to local anesthetics or opioid medications
• Infection at the planned block site
• History of alcohol or drug dependence
• Use of anticoagulant therapy
• Refusal to participate in the study

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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90 participants in 3 patient groups

Recto-intercostal fascial plane block

Active Comparator group

Description:

RIFP block will be performed, and standard postoperative pain management protocols will be applied.

Treatment:

Procedure: Recto-Intercostal Fascial Plane Block

Other: Post-operative Pain Management

Transversus abdominis plane block

Active Comparator group

Description:

TAP block will be performed, and standard postoperative pain management protocols will be applied.

Treatment:

Procedure: Transversus- Abdominis Plane Block

Other: Post-operative Pain Management

Control group

Active Comparator group

Description:

Standard postoperative pain management protocols will be applied. No plane block will be applied.

Treatment:

Other: Post-operative Pain Management