Authors: Tong C et al.
Anesthesiology, November 11, 2025 DOI: 10.1097/ALN.0000000000005846
Summary
This randomized controlled study evaluated the effectiveness of an ultrasound-guided external oblique intercostal (EOI) plane block for analgesia after open hepatectomy. Seventy adult patients at Zhongshan Hospital were randomized to receive either an EOI block using 30 ml of 0.375% ropivacaine or a saline placebo. All patients received standard patient-controlled intravenous analgesia (PCIA).
The primary outcome—24-hour postoperative opioid consumption—was significantly lower in the EOI group. The reduction was modest at 24 hours (–2.91 mg IV morphine equivalent) but became more clinically notable by 36 and 48 hours (–4.66 mg and –6.06 mg, respectively). Patients receiving the EOI block required less intraoperative fentanyl, had lower resting VAS pain scores, and had a longer interval before first rescue analgesia. However, pain scores during coughing were similar between groups.
The EOI block did not improve QoR-15 scores, length of stay, or rates of chronic pain at three months. Importantly, no block-related complications were observed. Overall, the EOI block provided an opioid-sparing benefit and improved resting pain control without adding measurable risk.
What You Should Know
• Seventy patients randomized to EOI block vs placebo for open hepatectomy.
• EOI block reduced opioid consumption at 24, 36, and 48 hours.
• Lower resting pain scores and less intraoperative fentanyl use in the block group.
• No improvement in coughing pain, QoR-15, hospital stay, or chronic pain.
• No complications from the EOI block.
• EOI block appears safe and beneficial as an adjunct for hepatectomy analgesia.
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