Laparoscopic Cholecystectomy, Postoperative Pain Management, Regional Anesthesia
Conditions
Keywords
regional anesthesia, Pain Management, Sensory Mapping, serratus intercostal plane block, external oblique plane block, eopb, sipb
Brief summary
This prospective observational study aims to evaluate and compare the sensory block distribution and regression patterns of two regional anesthesia techniques - External Oblique Plane Block (EOPB) and Serratus Intercostal Plane Block (SIPB) - in patients undergoing laparoscopic cholecystectomy. Thirty adult patients (ASA I-III, BMI ≤ 35 kg/m², ≥50 kg) scheduled for elective laparoscopic cholecystectomy procedures will be included, with 20 in each block group. Sensory block areas will be assessed using pinprick test, and dermatomal mapping will visualize the spread. The findings are expected to improve understanding of block behavior and guide multimodal analgesia strategies in laparoscopic cholecystectomy.
Detailed description
This single-center, prospective observational study will be conducted at Samsun University Training and Research Hospital operating rooms between November 2025 and June 2026. The study will include patients aged 18-75 years, classified as ASA I-III, who are scheduled for elective laparoscopic cholecystectomy and have provided written informed consent. For pain management, these patients will undergo either serratus intercostal plane block (SIPB) or external oblique plane block (EOPB) under ultrasound guidance. Patients receiving one of these two block techniques will be observed, and the sensory block areas created will be evaluated. Both blocks will be performed bilaterally and under ultrasound guidance immediately before surgery. 0.25% bupivacaine will be used for the block applications, and 25 mL of local anesthetic will be injected into each side (a total of 50 mL). Thirty minutes after the block, patients will be evaluated for cutaneous sensory block using the "pinprick test." This evaluation will be standardized according to specific dermatome levels, covering the midline and both abdominal quadrants, in order to describe sensory loss on the skin. The data obtained will be analyzed to determine the dermatomal spread and the minimum and maximum areas of effect of the blocks. Additionally, findings related to block application time will be recorded observationally. A comparison between the groups will be made, and the degree of overlap between the sensory block areas and the surgical incision site will be evaluated.
Interventions
PROCEDUREExternal Oblique Plane Block (EOPB)
Ultrasound-guided External Oblique Plane Block (EOPB) performed bilaterally using 0.25% bupivacaine (25 mL per side, total 50 mL) for postoperative analgesia in laparoscopic cholecystectomy.
PROCEDURESerratus Intercostal Plane Block (SIPB)
Ultrasound-guided Serratus Intercostal Plane Block (SIPB) performed bilaterally using 0.25% bupivacaine (25 mL per side, total 50 mL) for postoperative analgesia in laparoscopic cholecystectomy.
Sponsors
Samsun University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Patients scheduled for elective laparoscopic cholecystectomy surgery and who have received a regional anesthesia technique for this purpose. * Aged between 18-75 years. * Belonging to ASA I-III group. * Having provided written informed consent.
Exclusion criteria
* Patients who refuse to participate. * Patients who did not receive a block. * Patients classified as ASA IV. * History of previous abdominal surgery (affecting the laparoscopic approach). * Patients with cognitive dysfunction or inability to cooperate. * Patients diagnosed with psychiatric disorders (schizophrenia, mania, depression, etc.). * Patients who have been using antipsychotic medication for more than 4 weeks.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cutaneous Sensory Block Area of EOPB and SIPB | 30 minutes after block application | The primary outcome is the dermatomal mapping of the cutaneous sensory block areas produced by the serratus intercostal plane block (SIPB) and external oblique plane block (EOPB), and the comparison of sensory block extent between the two techniques. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Coverage of Surgical Port Entry Sites by the Sensory Block Area | 30 minutes after block application | After examination and mapping of the cutaneous sensory area, surgical port entry sites will be marked on the patient by the surgeon. Port entry sites covered and not covered by the sensory block area will be assessed and compared between the two groups on a percentage basis. |
| Maximum and Minimum Spread of the Cutaneous Sensory Block Area | 30 minutes after block application | The minimum and maximum dermatomal boundaries of the cutaneous sensory block area produced by each regional anesthesia technique will be assessed using sensory mapping and compared between the two groups. |
| Block Application Duration | From needle insertion to completion of local anesthetic injection | During regional anesthesia administration, the duration of block application will be measured in minutes for each technique and compared between the two groups. |
Countries
Turkey (Türkiye)
Contacts
CONTACTHatice Selcuk Kusderci, M.D.
CONTACTMert Yılmaz, M.D.
PRINCIPAL_INVESTIGATORHatice Selcuk Kusderci, M.D.
Samsun University Training and Research Hospital
Outcome results
None listed