A Comparative Study Between Ultrasound Guided External Oblique Intercostal Plane (EOIP) Block and Erector Spinae Plane (ESP) Block for Postoperative Analgesia in Upper Abdominal Surgeries: A Randomized Controlled Trial

Abstract

Background: Upper abdominal laparotomies can cause severe discomfort and restrict breathing. Local anesthetic (LA) deposition in the paraspinal fascial plane is known as the erector spinae plane (ESP) block, which offers both somatic and visceral analgesia. The LA deposition in the fascial plane beneath the external oblique muscle at the sixth intercostal space is known as the external oblique intercostal plane (EOIP) block, targeting the thoracoabdominal nerves (T6 to T11). Objectives: To investigate the effectiveness of ultrasound (US)-guided EOIP block compared to ultrasound-guided erector spinae plane (US-ESP) block for pain relief following upper abdominal procedures. Methods: Patients were randomly divided into three equal groups (25 each). The EOIP group received an US guided EOIP block. The ESP group received a US guided ESP block. The control group did not receive any blocks and received postoperative IV analgesia according to hospital protocol (morphine 0.1 mg/kg). Results: The time to first pethidine administration was significantly shorter in the control group, with no significant differences observed between the EOIP and ESP groups. The total 24-hour pethidine dose was significantly highest in the control group, with no significant differences between the EOIP and ESP groups. The duration to mobilization was significantly prolonged in the control group, with no significant differences observed between the EOIP and ESP groups. The duration of the technique was significantly shorter in the EOIP group. The ease of technique score was significantly superior in the EOIP group compared to the ESP group. Conclusions: Both the EOIP block and ESP block provide efficient analgesia for upper surgical procedures on the abdomen; however, the EOIP block has the advantage of being easier to perform and requiring less time.