- Design
- Single-centre, prospective, randomised parallel-group trial
- Population
- 56 adults having elective laparoscopic cholecystectomy
- Primary outcome
- Total butorphanol consumption in the first 24 hours
- Effect
- 46.5% lower consumption (95% CI 38.3 to 53.6); median 3.7 mg versus 7.2 mg
In a single-centre trial, 56 patients having elective laparoscopic cholecystectomy were randomised to a bilateral ultrasound-guided external oblique intercostal plane block or no block. All received standard anaesthesia and butorphanol patient-controlled analgesia.
Median 24-hour butorphanol use was 3.7 mg with the block versus 7.2 mg without, and after adjustment consumption was 46.5% lower (95% CI 38.3 to 53.6). The block group had higher recovery scores at 24 hours (median 140 versus 131), earlier first flatus (18 versus 20 hours) and lower cough-pain scores. Intraoperative haemodynamics did not differ.
The trial is small, from one centre, with no blinding described in the abstract, and the primary outcome was opioid consumption rather than pain or safety. It supports trying the block within an enhanced recovery pathway, with the anaesthesia team's skill and local resources deciding feasibility.
- Block cut 24-hour butorphanol use by 46.5% after adjustment.
- Quality of recovery score was higher at 24 hours.
- First flatus came about two hours sooner.
- Only 56 patients at one centre.
- Raise regional options with your anaesthesia team for elective laparoscopic cholecystectomy.
Why it matters
It points to a regional technique that spares opioids without longer operating time or haemodynamic cost.
Don't overread it
This was a single-centre trial of 56 patients with opioid use as the main outcome, so it cannot establish safety or long-term benefit.
The statistics, in plain English
A 46.5% reduction with an interval of 38.3% to 53.6% is precise for opioid consumption in this trial, but 28 patients per arm limits what it can say about rarer complications or about other settings.
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