Effect of Ultrasound-Guided External Oblique Intercostal Fascial Plane Block on Hospital Length of Stay and Postoperative Analgesia in Geriatric Patients Undergoing Laparoscopic Cholecystectomy

Abstract

Background: Effective postoperative pain management in geriatric patients undergoing laparoscopic cholecystectomy is essential to facilitate early recovery, reduce opioid-related adverse effects, and shorten hospital stay. The ultrasound-guided external oblique intercostal fascial plane (EOIC) block is a novel regional anaesthetic technique that provides analgesia to the upper abdominal wall by blocking the anterior and lateral cutaneous branches of the thoracoabdominal nerves. This prospective randomized controlled trial evaluated the effect of bilateral EOIC block on hospital length of stay and postoperative analgesia in geriatric patients undergoing laparoscopic cholecystectomy. Sixty patients aged ≥65 years were randomly allocated to receive either bilateral ultrasound-guided EOIC block with 0.25% levobupivacaine and dexamethasone (Group E, n=30) or bilateral normal saline (Group C, n=30) following induction of general anaesthesia. The primary outcomes were hospital length of stay and postoperative visual analogue scale (VAS) pain scores during the first 24 hours. Secondary outcomes included postoperative opioid consumption and perioperative haemodynamic parameters. Patients receiving EOIC block demonstrated significantly lower postoperative VAS scores from 16 to 24 hours and a significantly shorter hospital length of stay than the control group (p<0.05). Postoperative opioid consumption was also lower in the EOIC group. Ultrasound-guided EOIC block appears to be an effective adjunct to multimodal analgesia in geriatric patients undergoing laparoscopic cholecystectomy and may facilitate enhanced recovery and earlier hospital discharge.