Overview
n obese patients, adequate pain relief in the postoperative period is a crucial parameter that affects patient comfort and hospital stay. Improving patient comfort and recovery quality can be achieved by minimizing undesirable effects such as nausea, vomiting, and inadequate analgesia. This study aimed to evaluate the impact of the external oblique intercostal block on postoperative dermatomal distribution, acute pain scores, and opioid consumption during the first 24 hours after laparoscopic sleeve gastrectomy surgery.
Description
In this observational study, patients undergoing laparoscopic sleeve gastrectomy who received either superficial or deep parasternal intercostal plane blocks were evaluated for sensory distribution. Sensory assessment was conducted by a blinded investigator 30 minutes after block administration. Cold sensation testing was performed using small ice tubes applied to the abdominal wall. Sensations were categorized as Normal, Reduced, or No cold.
A successful block was defined as the loss or reduction of cold sensitivity within the expected dermatomal distribution, whereas a normal cold sensation was considered block failure. Assessments began at the midline, including the epigastric region and trocar insertion sites, and progressed laterally toward the anterior axillary line. The extent of sensory coverage was recorded on the skin surface, and marked dermatomal areas were subsequently subjected to digital analysis.
To evaluate block duration, regression of sensory changes was reassessed at 12 and 24 hours postoperatively using the same cold sensation criteria.
Eligibility
Inclusion Criteria:
- 18-65 years
Exclusion Criteria:
- Patients who did not sign the informed consent form and did not wish to participate in the study
- Patients with a history of opioid use lasting longer than four weeks
- Patients with chronic pain
- Patients with a history of allergy or hypersensitivity to local anesthetics or opioids
- Presence of severe cardiac, hepatic, or renal disease
- Patients with alcohol or drug addiction
- Conditions contraindicating the application of regional anesthesia
- Patients with severe psychiatric disorders such as psychosis or dementia that limit cooperation
- Block failure identified by dermatomal examination after the procedure
- Patients with a STOP-BANG score > 5