Background: Laparoscopic sleeve gastrectomy (LSG) causes significant postoperative pain, necessitating effective multimodal analgesia strategies. This study evaluated the efficacy of the external oblique intercostal block (EOIB) in this context. Methods: This prospective, randomized, controlled, single-blind study conducted between April and December 2023 included 60 patients who underwent LSG. Patients were divided into the EOIB (30 ml 0.25% bupivacaine/side) and control (no block) groups. The primary outcome was the cumulative intravenous morphine milligram equivalent (MME) consumption in the first 24 h postoperatively. Secondary outcomes included 12-h MME consumption, pain scores, intraoperative remifentanil use, rescue analgesia requirements, time to first analgesic request, nausea/vomiting scores, antiemetic use, and American Pain Society Patient Outcome Questionnaire-Revised Turkish Version (APS-POQ-R-TR) scores. Results: The control group had significantly higher median opioid consumption than the EOIB group at 12 (14.4 vs. 5.8 mg; P < 0.001) and 24 h (25.9 vs. 10.6 mg; P < 0.001) postoperatively. The need for rescue analgesics did not differ significantly (43.3 vs. 23.3%; P = 0.1). The EOIB group exhibited significantly higher patient satisfaction (APS-POQ-R-TR score 2.91 vs. 4.42; P < 0.001) and consistently lower pain scores across all time points (P < 0.001). The EOIB group had lower nausea/vomiting scores (P < 0.001), fewer patients requiring antiemetics (16.7% vs. 40%; P = 0.045), longer time to first morphine request (57.5 vs. 25 min; P < 0.001), and lower remifentanil use (850 vs. 1050 μg; P < 0.001). Conclusions The preoperative EOIB, as a part of multimodal analgesia, provides effective analgesia for acute pain in patients undergoing LSG.

Background: Laparoscopic sleeve gastrectomy (LSG) causes significant postoperative pain, necessitating effective multimodal analgesia strategies. This study evaluated the efficacy of the external oblique intercostal block (EOIB) in this context. Methods: This prospective, randomized, controlled, single-blind study conducted between April and December 2023 included 60 patients who underwent LSG. Patients were divided into the EOIB (30 ml 0.25% bupivacaine/side) and control (no block) groups. The primary outcome was the cumulative intravenous morphine milligram equivalent (MME) consumption in the first 24 h postoperatively. Secondary outcomes included 12-h MME consumption, pain scores, intraoperative remifentanil use, rescue analgesia requirements, time to first analgesic request, nausea/vomiting scores, antiemetic use, and American Pain Society Patient Outcome Questionnaire-Revised Turkish Version (APS-POQ-R-TR) scores. Results: The control group had significantly higher median opioid consumption than the EOIB group at 12 (14.4 vs. 5.8 mg; P < 0.001) and 24 h (25.9 vs. 10.6 mg; P < 0.001) postoperatively. The need for rescue analgesics did not differ significantly (43.3 vs. 23.3%; P = 0.1). The EOIB group exhibited significantly higher patient satisfaction (APS-POQ-R-TR score 2.91 vs. 4.42; P < 0.001) and consistently lower pain scores across all time points (P < 0.001). The EOIB group had lower nausea/vomiting scores (P < 0.001), fewer patients requiring antiemetics (16.7% vs. 40%; P = 0.045), longer time to first morphine request (57.5 vs. 25 min; P < 0.001), and lower remifentanil use (850 vs. 1050 μg; P < 0.001). Conclusions The preoperative EOIB, as a part of multimodal analgesia, provides effective analgesia for acute pain in patients undergoing LSG.

Background: Laparoscopic sleeve gastrectomy (LSG) causes significant postoperative pain, necessitating effective multimodal analgesia strategies. This study evaluated the efficacy of the external oblique intercostal block (EOIB) in this context. Methods: This prospective, randomized, controlled, single-blind study conducted between April and December 2023 included 60 patients who underwent LSG. Patients were divided into the EOIB (30 ml 0.25% bupivacaine/side) and control (no block) groups. The primary outcome was the cumulative intravenous morphine milligram equivalent (MME) consumption in the first 24 h postoperatively. Secondary outcomes included 12-h MME consumption, pain scores, intraoperative remifentanil use, rescue analgesia requirements, time to first analgesic request, nausea/vomiting scores, antiemetic use, and American Pain Society Patient Outcome Questionnaire-Revised Turkish Version (APS-POQ-R-TR) scores. Results: The control group had significantly higher median opioid consumption than the EOIB group at 12 (14.4 vs. 5.8 mg; P < 0.001) and 24 h (25.9 vs. 10.6 mg; P < 0.001) postoperatively. The need for rescue analgesics did not differ significantly (43.3 vs. 23.3%; P = 0.1). The EOIB group exhibited significantly higher patient satisfaction (APS-POQ-R-TR score 2.91 vs. 4.42; P < 0.001) and consistently lower pain scores across all time points (P < 0.001). The EOIB group had lower nausea/vomiting scores (P < 0.001), fewer patients requiring antiemetics (16.7% vs. 40%; P = 0.045), longer time to first morphine request (57.5 vs. 25 min; P < 0.001), and lower remifentanil use (850 vs. 1050 μg; P < 0.001). Conclusions The preoperative EOIB, as a part of multimodal analgesia, provides effective analgesia for acute pain in patients undergoing LSG.

Background: Laparoscopic sleeve gastrectomy (LSG) causes significant postoperative pain, necessitating effective multimodal analgesia strategies. This study evaluated the efficacy of the external oblique intercostal block (EOIB) in this context. Methods: This prospective, randomized, controlled, single-blind study conducted between April and December 2023 included 60 patients who underwent LSG. Patients were divided into the EOIB (30 ml 0.25% bupivacaine/side) and control (no block) groups. The primary outcome was the cumulative intravenous morphine milligram equivalent (MME) consumption in the first 24 h postoperatively. Secondary outcomes included 12-h MME consumption, pain scores, intraoperative remifentanil use, rescue analgesia requirements, time to first analgesic request, nausea/vomiting scores, antiemetic use, and American Pain Society Patient Outcome Questionnaire-Revised Turkish Version (APS-POQ-R-TR) scores. Results: The control group had significantly higher median opioid consumption than the EOIB group at 12 (14.4 vs. 5.8 mg; P < 0.001) and 24 h (25.9 vs. 10.6 mg; P < 0.001) postoperatively. The need for rescue analgesics did not differ significantly (43.3 vs. 23.3%; P = 0.1). The EOIB group exhibited significantly higher patient satisfaction (APS-POQ-R-TR score 2.91 vs. 4.42; P < 0.001) and consistently lower pain scores across all time points (P < 0.001). The EOIB group had lower nausea/vomiting scores (P < 0.001), fewer patients requiring antiemetics (16.7% vs. 40%; P = 0.045), longer time to first morphine request (57.5 vs. 25 min; P < 0.001), and lower remifentanil use (850 vs. 1050 μg; P < 0.001). Conclusions The preoperative EOIB, as a part of multimodal analgesia, provides effective analgesia for acute pain in patients undergoing LSG.

Background: Different regional anesthesia (RA) techniques have been used for laparoscopic cholecystectomy (LC), but there is no consensus on their comparative effectiveness. Our objective was to evaluate the effect of RA techniques on patients undergoing LC using a network meta-analysis approach. Methods: We conducted a systematic review and network meta-analysis. We searched PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and Web of Science (Science and Social Science Citation Index) using the following PICOS criteria: (P) adult patients undergoing LC; (I) any RA single-shot technique with injection of local anesthetics; (C) placebo or no intervention; (O) postoperative opioid consumption expressed as morphine milligram equivalents (MME), rest pain at 12 h and 24 h post-operation, postoperative nausea and vomiting (PONV), length of stay; and (S) randomized controlled trials. Results: A total of 84 studies were included. With the exception of the rectus sheath block (P = 0.301), the RA techniques were superior to placebo at reducing opioid consumption. Regarding postoperative pain, the transversus abdominis plane (TAP) block (−1.80 on an 11-point pain scale) and erector spinae plane (ESP) block (−1.33 on an 11-point pain scale) were the most effective at 12 and 24 h. The TAP block was also associated with the greatest reduction in PONV. Conclusions RA techniques are effective at reducing intraoperative opioid use, postoperative pain, and PONV in patients undergoing LC. Patients benefit the most from the bilateral paravertebral, ESP, quadratus lumborum, and TAP blocks.