Evaluation of the analgesic efficacy of ultrasound-guided bilateral high-volume recto-intercostal plane block in laparoscopic sleeve gastrectomy: a prospective randomized controlled trial
Abstract
Background: Postoperative pain control is important in patients with obesity undergoing laparoscopic bariatric surgery, as inadequate analgesia may increase opioid consumption and delay recovery. Ultrasound-guided fascial plane blocks are increasingly used as part of multimodal analgesia. The recto-intercostal plane block (RIPB) is a recently described technique that may provide effective upper abdominal wall analgesia when applied bilaterally with a high-volume approach. However, evidence regarding its efficacy in bariatric surgery is limited. This study aimed to evaluate whether bilateral ultrasound-guided RIPB reduces postoperative opioid consumption and improves recovery after laparoscopic sleeve gastrectomy.
Methods: This prospective, randomized, assessor-blinded controlled trial included 56 patients with obesity undergoing elective laparoscopic sleeve gastrectomy under general anesthesia. Patients were allocated to receive either bilateral ultrasound-guided RIPB at the end of surgery (RIPB group, n = 28) or standard analgesic management without regional block (Control group, n = 28). The RIPB was performed using bupivacaine diluted to a final concentration of 0.25% and a total volume of 60 mL, with 30 mL administered per side. All patients received standardized multimodal analgesia and intravenous patient-controlled analgesia with morphine. The primary outcome was cumulative intravenous morphine consumption within the first 24 postoperative hours. Secondary outcomes…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 56 participants or records.
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