Bilateral External Oblique İntercostal (EOI) Plane Block in Patients Undergoing Laparoscopic Cholecystectomy.
Condition: Laparoscopic Cholecystectomy
Study type: Interventional

Summary: 
      This study will define the postoperative analgesic effect of ultrasound-guided bilateral
      External Oblique İntercostal (EOI) Plane Block and compare the control group in patients
      undergoing laparoscopic cholecystectomy.

      The aim of this study is to compare postoperative opioid consumption of EOI plane block
      versus control group. It is hypothesized that postoperative opioid use will be less in
      patients with EOI plane block than in patients who only receive routine multimodal analgesia.
    

Detailed description: 
      Laparoscopy is a minimally invasive procedure, but postoperative pain is still the most
      common symptom after laparoscopic cholecystectomy (LC). Regional blocks used in addition to
      multimodal analgesia for postoperative pain after LC usually block the anterior branches of
      the intercostal nerves. After it was suggested by Hamilton et al. in 2018 that it could block
      the lateral cutaneous branches between T7-T11 intercostal nerve by administering local
      anesthetic to the thoracic facial plane and could be used in lateral abdominal surgeries, the
      EOI plane block has become a block that can be used for analgesic purposes in upper and
      lateral abdominal surgeries. Blocking the anterior and lateral branches together may produce
      analgesia in a wider area, resulting in less postoperative opioid consumption.

      This study will be conducted as a single-center, prospective, randomized trial in a
      university hospital. Patients scheduled for elective laparoscopic cholecystectomy will be
      screened for enrollment in the study. After randomization, EOI Plane Block will be performed
      under ultrasound guidance after administering general anesthesia and prior to the skin
      incision. An anesthesiologist who performed blocks will not involve in the data collection.
      Other health care workers who will involve in the evaluation of postoperative opioid
      consumption,pain scores, nausea and vomiting, antiemetic use, and Quality of Recovery score
      will be blinded to group assignment.
    

Intervention name(s): Bilateral External Oblique İntercostal (EOI) Plane Block; Standard perioperative and postoperative multimodal analgesia
Intervention type(s): Other; Other
Intervention description(s): External Oblique İntercostal (EOI) Plane Block will be provided for postoperative pain for Laparoscopic Cholecystectomy with Bupivacaine. And patients will receive standard multimodal analgesia comprising paracetamol, deksketoprofen, and tramadol.; Patients will receive standard multimodal analgesia comprising paracetamol, deksketoprofen, and tramadol for Laparoscopic Cholecystectomy.
Other intervention name(s): Quality of Recovery-15 score; Standard Pain Followup and Monitorization; Quality of Recovery-15 score; Standard Pain Followup and Monitorization
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: There are two group;
Experimental Group: Group (EOI) Plane Block ; A block needle will inserted with in-plane technique and 25 ml 0.25 bupivacaine will be applied to EOI plane. The same procedure will be repeated on the contralateral side. Patients will receive standard multimodal analgesia comprising paracetamol, deksketoprofen, and tramadol.
Sham Comparator Group:The patients will not receive any intervention. Patients will receive standard multimodal analgesia comprising paracetamol, deksketoprofen, and tramadol.
Masking: Triple (Participant, Care Provider, Investigator)
Primary purpose: Treatment
Keywords: Laparoscopic Cholecystectomy; Acute Postoperative Pain; Nerve block