Author: Srinivasaraghavan N et al.
A & A Practice 19(7): e02019. doi:10.1213/XAA.0000000000002019
This double-blinded, randomized controlled trial compared ultrasound-guided external oblique intercostal block (EOIB) with intravenous morphine as rescue analgesia for patients experiencing moderate to severe pain despite epidural analgesia after upper abdominal surgery. Sixty-six patients were randomized equally to EOIB or IV morphine.
The EOIB group had significantly lower 24-hour morphine requirements (median 0 mg vs 2.5 mg; P = .006) and longer pain-free periods (median 4 hours vs 0 hours; P = .015). EOIB also showed higher early percentage pain intensity difference (66.6% vs 50%; P = .002) and superior summated pain intensity differences at 8 and 24 hours. Two EOIB patients achieved complete pain relief for 24 hours, compared to none in the morphine group. No significant adverse events occurred.
The study concludes that EOIB offers superior and prolonged analgesia compared to IV morphine, reduces opioid use, and extends pain-free time when used alongside epidural analgesia for upper abdominal surgery.
References
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Srinivasaraghavan N, Seshadri RA, Ramasamy Y, et al. A & A Pract. 2025;19:e02019. doi:10.1213/XAA.0000000000002019.
Thank you to A & A Practice for providing this evidence on the effectiveness of EOIB for postoperative pain after upper abdominal surgery.