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This prospective observational study aims to evaluate and compare the sensory block distribution and regression patterns of two regional anesthesia techniques - External Oblique Plane Block (EOPB) and Serratus Intercostal Plane Block (SIPB) - in patients undergoing laparoscopic cholecystectomy.
Thirty adult patients (ASA I-III, BMI ≤ 35 kg/m², ≥50 kg) scheduled for elective laparoscopic cholecystectomy procedures will be included, with 20 in each block group. Sensory block areas will be assessed using pinprick test, and dermatomal mapping will visualize the spread. The findings are expected to improve understanding of block behavior and guide multimodal analgesia strategies in laparoscopic cholecystectomy.
This single-center, prospective observational study will be conducted at Samsun University Training and Research Hospital operating rooms between November 2025 and June 2026.
The study will include patients aged 18-75 years, classified as ASA I-III, who are scheduled for elective laparoscopic cholecystectomy and have provided written informed consent. For pain management, these patients will undergo either serratus intercostal plane block (SIPB) or external oblique plane block (EOPB) under ultrasound guidance. Patients receiving one of these two block techniques will be observed, and the sensory block areas created will be evaluated.
Both blocks will be performed bilaterally and under ultrasound guidance immediately before surgery. 0.25% bupivacaine will be used for the block applications, and 25 mL of local anesthetic will be injected into each side (a total of 50 mL). Thirty minutes after the block, patients will be evaluated for cutaneous sensory block using the "pinprick test." This evaluation will be standardized according to specific dermatome levels, covering the midline and both abdominal quadrants, in order to describe sensory loss on the skin.
The data obtained will be analyzed to determine the dermatomal spread and the minimum and maximum areas of effect of the blocks. Additionally, findings related to block application time will be recorded observationally. A comparison between the groups will be made, and the degree of overlap between the sensory block areas and the surgical incision site will be evaluated.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| EOPB Group | Patients undergoing laparoscopic cholecystectomy who receive an ultrasound-guided External Oblique Plane Block (EOPB) for postoperative analgesia. Bilateral blocks will be performed using 0.25% bupivacaine (25 mL per side, total 50 mL). Sensory block areas will be evaluated using pinprick at predefined time points. |
| |
| SIPB Group | Patients undergoing laparoscopic cholecystectomy who receive an ultrasound-guided Serratus Intercostal Plane Block (SIPB) for postoperative analgesia. Bilateral blocks will be performed using 0.25% bupivacaine (25 mL per side, total 50 mL). Sensory block areas will be evaluated using pinprick at predefined time points. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| External Oblique Plane Block (EOPB) | Procedure | Ultrasound-guided External Oblique Plane Block (EOPB) performed bilaterally using 0.25% bupivacaine (25 mL per side, total 50 mL) for postoperative analgesia in laparoscopic cholecystectomy. |
| Measure | Description | Time Frame |
|---|---|---|
| Cutaneous Sensory Block Area of EOPB and SIPB | The primary outcome is the dermatomal mapping of the cutaneous sensory block areas produced by the serratus intercostal plane block (SIPB) and external oblique plane block (EOPB), and the comparison of sensory block extent between the two techniques. | 30 minutes after block application |
| Measure | Description | Time Frame |
|---|---|---|
| Coverage of Surgical Port Entry Sites by the Sensory Block Area | After examination and mapping of the cutaneous sensory area, surgical port entry sites will be marked on the patient by the surgeon. Port entry sites covered and not covered by the sensory block area will be assessed and compared between the two groups on a percentage basis. | 30 minutes after block application |
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Inclusion Criteria:
Exclusion Criteria:
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Patients who are scheduled to undergo elective laparoscopic cholecystectomy surgery under general anesthesia at the Department of Anesthesiology, Samsun University Training and Research Hospital. A total of 40 patients will be enrolled and divided into two groups: EOPB (n=20) and SIPB (n=20). Each participant will receive ultrasound-guided regional anesthesia according to their assigned group, and sensory mapping will be performed postoperatively.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Hatice Selcuk Kusderci, M.D. | Contact | +905052159896 | drkusderci@hotmail.com | |
| Mert Yılmaz, M.D. | Contact | +905326699555 | dryilmazmert@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Hatice Selcuk Kusderci, M.D. | Samsun University Training and Research Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Samsun University, Samsun Training and Research Hospital | Recruiting | Samsun | Ilkadım | 55200 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29381568 | Background | Nielsen TD, Moriggl B, Barckman J, Kolsen-Petersen JA, Soballe K, Borglum J, Bendtsen TF. The Lateral Femoral Cutaneous Nerve: Description of the Sensory Territory and a Novel Ultrasound-Guided Nerve Block Technique. Reg Anesth Pain Med. 2018 May;43(4):357-366. doi: 10.1097/AAP.0000000000000737. | |
| 40449315 | Background |
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| ID | Term |
|---|---|
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
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| Serratus Intercostal Plane Block (SIPB) | Procedure | Ultrasound-guided Serratus Intercostal Plane Block (SIPB) performed bilaterally using 0.25% bupivacaine (25 mL per side, total 50 mL) for postoperative analgesia in laparoscopic cholecystectomy. |
|
| Maximum and Minimum Spread of the Cutaneous Sensory Block Area | The minimum and maximum dermatomal boundaries of the cutaneous sensory block area produced by each regional anesthesia technique will be assessed using sensory mapping and compared between the two groups. | 30 minutes after block application |
| Block Application Duration | During regional anesthesia administration, the duration of block application will be measured in minutes for each technique and compared between the two groups. | From needle insertion to completion of local anesthetic injection |
| Dost B, Turunc E, Kaya C, Sahin CA, Genc C, Yucel SM, Demirag MK, Karakaya D. Maximum extension and regression rate of cutaneous sensory block: superficial vs. deep parasternal intercostal plane blocks in patients undergoing open cardiac surgery. J Clin Anesth. 2025 Jul;105:111888. doi: 10.1016/j.jclinane.2025.111888. Epub 2025 May 30. |
| 39545654 | Background | Genc C, Tulgar S, Akgun C, Avci MA, Yesilyurt B, Yildiz B, DE Cassai A. Maximum extension and regression rate of cutaneous sensory block obtained with the external oblique intercostal block or the modified thoracoabdominal nerves block through perichondrial approach in patients undergoing laparoscopic cholecystectomy. Minerva Anestesiol. 2024 Nov;90(11):979-988. doi: 10.23736/S0375-9393.24.18213-2. |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |