Is a Combination of the Serratus Intercostal Plane Block and Rectus Sheath Block Superior to the Bilateral Oblique Subcostal Transversus Abdominis Plane Block in Laparoscopic Cholecystectomy?

Introduction: The serratus intercostal plane block is a recently defined interfascial plane block. Oblique subcostal transversus abdominis plane block is another interfascial plane block and is also used as part of multimodal analgesia in patients undergoing laparoscopic cholecystectomy. In this retrospective study, we evaluated the effects of bilateral oblique subcostal transversus abdominis plane block and combination of the right serratus intercostal plane block and bilateral rectus sheath block on postoperative pain and analgesia requirement in laparoscopic cholecystectomy patients.

Material and Methods: Data of patients who underwent LC between May 2018 and November 2018 were evaluated retrospectively. Postoperative pain was evaluated with The Numeric Rating Scale (NRS) .24 hour tramadol consumption and rescue analgesia requirements were compared.

Results: Bilateral OSTAP was applied to 47 patients and serratus intercostal plane block + rectus sheath block was applied to 25 patients. Postoperative pain scores were similar between the two groups. In the first 24 hours of tramadol requirement in serratus intercostal plane block + rectus sheath block group was significantly lower than in oblique subcostal transversus abdominis plane block group (p <0.001). There was no statistically significant difference between NRS averages at different time frames between two block groups.

Conclusion: We found that when serratus intercostal plane block is used as a part of multimodal analgesia in combination with rectus sheath block in laparoscopic cholecystectomy, it improved the quality of analgesia and decreased analgesic requirement compared to patients undergoing bilateral oblique subcostal transversus abdominis plane block. Randomized controlled trials are needed to compare the effect of SIPB alone and in combination with other blocks in laparoscopic cholecystectomy. 

Cite this article as: Selvi O, Tulgar S, Senturk O, et al. Is a Combination of the Serratus Intercostal Plane Block and Rectus Sheath Block Superior to the Bilateral Oblique Subcostal Transversus Abdominis Plane Block in Laparoscopic Cholecystectomy? Eurasian J Med 2020; 52(1): 34-7.