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Randomized Controlled Trial
. 2025 Apr 16;25(1):186.
doi: 10.1186/s12871-025-03062-6.

The effect of bilateral rectus sheath and oblique subcostal transversus abdominis plane blocks on mechanical power in patients undergoing laparoscopic cholecystectomy surgery: a randomized controlled trial

Esma Karaarslan  1 , Yasin Tire  2 , Mahmut Sami Tutar  2 , Nuran Akıncı  2 , Hasan Alp Mermer  2 , Sami Uyar  3 , Dilek Ateş  2 , Gürcan Şimşek  4 , Betül Kozanhan  2
Affiliations
Randomized Controlled Trial

The effect of bilateral rectus sheath and oblique subcostal transversus abdominis plane blocks on mechanical power in patients undergoing laparoscopic cholecystectomy surgery: a randomized controlled trial

Esma Karaarslan et al. BMC Anesthesiol. .

Abstract

Background: In this study, we aimed to investigate the effects of bilateral rectus sheath blocks (RSBs) and oblique subcostal transversus abdominis plane (OSTAP) blocks on mechanical power (MP) in patients receiving laparoscopic cholecystectomy under general anesthesia. Additionally, we sought to evaluate the impact of these blocks on postoperative pain and quality of patient recovery.

Methods: In this prospective, double-blind study, 66 patients who underwent laparoscopic cholecystectomy were randomized into two groups: Group C (control), which received a standard analgesic intravenous regimen; and Group B (block), which received bilateral RSB and OSTAP blocks. Intraoperative mechanical power was measured for all patients. Postoperative pain was assessed using visual analog scale (VAS) scores, and recovery quality was measured using the 15-item quality of recovery (QoR-15) questionnaire.

Results: The mechanical power values for patients in Group C were consistently greater at all measured times: baseline, before bridion, and after bridion. Although the difference at baseline was not statistically significant, significant differences were observed before and after bridion (p values = 0.112, 0.021, and 0.003, respectively). Patients in Group B exhibited significantly lower VAS scores at all time points (30 min, 2 h, 8 h, and 24 h) (p < 0.05). Additionally, essential variations were noted in the administration of rescue analgesia between the groups (p < 0.001). Regarding tramadol consumption, Group C patients had significantly greater values [84 (74-156) vs. 0 (0-75), median (25-75th percentiles)] (p < 0.001). For the QoR-15 scores, Group C also had significantly greater values [129 (124-133) vs. 122 (115-125), median (25-75th percentiles)] (p < 0.001).

Conclusions: Bilateral RSB and OSTAP blocks significantly reduce mechanical power during surgery. Moreover, they significantly decrease postoperative pain and analgesic consumption and increase patient recovery scores.

Trial registration: The study protocol was registered in the international database ClinicalTrials.gov (registration no. NCT06202040). This study was conducted between December 2023 and January 2024 at the Department of Anesthesiology and Reanimation of Konya City Hospital.

Keywords: Laparoscopic cholecystectomy surgery; Mechanical power; OSTAP blocks; Rectus sheath blocks.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Ethical approval was obtained from the Ethics Committee of Ankara Bilkent City Hospital (E1-23-4243; numbered and dated December 15, 2023, December) for this prospective, randomized, controlled, and double-blind study. The study protocol was registered in the international database ClinicalTrials.gov (registration no. NCT06202040), with the study starting at 2023-12-22 and completing at 2024-01-25. All patients provided written informed consent prior to their participation in the study and before any procedures were conducted. The study protocol conforms to the 2013 Declaration of Helsinki ethics guidelines. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the study
See this image and copyright information in PMC

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