Effects of Fascial Plan Blocks on Pulmonary Functions

Effects of External Oblique Fascial Plan Block and Subcostal Transversus Abdominis Plan Block on Postoperative Pulmonary Functions

In addition to the traumatic effect of the operation, the effort to immobilize the auxiliary respiratory muscles due to pain causes a decrease in postoperative respiratory function (especially in thoracic and upper abdominal surgeries). In addition, superficial and tachypneic breathing caused by the inability of the patient to take deep breaths with pain leads to closure of small airways and increase in intrapulmonary shunts, resulting in hypoxia. Postoperative pain management is important not only to prevent pain but also to reduce pulmonary complications that may occur due to changes in lung function and to reduce mortality and morbidity by controlling the stress response. Pain after nausea and vomiting is the most common reason for hospitalization after laparoscopic surgery.

Although pain in laparoscopic cholecystectomy (LC) has many components including incisional, visceral and reflected, the primary source of pain is incisional pain. A multimodal analgesic approach (NSAII, paracetamol, opioids, local infiltration, facial plane blocks and paravertebral and periparavertebral blocks) is recommended. Regional anesthesia combined with general anesthesia reduces the stress response associated with surgery and reduces the need for opioid use. Subcostal TAP Block; injection of local anesthetic between the internal oblique and transversus abdominis muscles in the upper quadrant of the anterior abdominal wall blocks the anterior cutaneous branches of the thoracoabdominal nerves. External Oblique Fascial Plane Block (EOIB); blocks both the anterior and lateral cutaneous branches of the thoracoabdominal nerves. It is performed between the 6th-7th costae. There is a cutaneous sensory block between T6-T9 in the midabdomen and T6-T10 in the anterior axillary line.

The conventional method is the administration of intravenous opioids as a method of postoperative analgesia when the routine block cannot be performed due to a contraindication.

Study Overview

• Status: Completed
• Conditions: Pain, Postoperative; Respiratory Function Loss
• Intervention / Treatment: Procedure: plane block

• Study Type: Observational
• Enrollment (Actual): 1

Contacts and Locations

Study Locations

• Turkey
  • Zonguldak
    • Kozlu, Zonguldak, Turkey, 67600
      • Zonguldak Bülent Ecevit University Faculty of Medicine

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: N/A

• Sampling Method: Probability Sample

Study Population

Patients who will undergo cholecystectomy between the ages of 18-65

Description

Inclusion Criteria:

• 18-65 years old
• ASA I-II-III risk group
• Patients whose consent was obtained with an informed consent form
• She will undergo a cholecystectomy operation
• Patients to be cooperative for SFT test

Exclusion Criteria:

• <18 years and >65 years
• ASA ≥ IV
• Pulmonary function test below 50% of the expected value
• Known diaphragm paralysis
• Body mass index >30
• Myocardial infarction within 1 month
• Dementia or confusion
• Lack of cooperation
• People with respiratory diseases
• Congestive heart failure
• Unstable hypertension
• Thoracoabdominal surgery

Study Plan

How is the study designed?

Number of groups / cohorts

3

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Control
External Oblique Fascial Plan Block	Procedure: plane block; injection of local anesthetic to the myofascial plane
Subcostal Transversus Abdominis Plan Block	Procedure: plane block; injection of local anesthetic to the myofascial plane

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
the effect of plane blocks on postoperative pulmonary function	The effect of pain relief after plane blocks on postoperative pulmonary function	during the postoperative 24 hours

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
opioid consumption	need for opioids as a result of pain	during the postoperative 24 hours
Incidence of nausea and vomiting	Need for nausea and vomiting	during the postoperative 24 hours
quality of recovery-15	Quality of recovery of patients by survey	during the postoperative 24 hours

Collaborators and Investigators

• Sponsor: Zonguldak Bulent Ecevit University

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2023
• Primary Completion (Actual): October 30, 2024
• Study Completion (Actual): December 31, 2024

Study Registration Dates

• First Submitted: November 16, 2023
• First Submitted That Met QC Criteria: November 16, 2023
• First Posted (Actual): November 22, 2023

Study Record Updates

• Last Update Posted (Actual): May 28, 2025
• Last Update Submitted That Met QC Criteria: May 21, 2025
• Last Verified: May 1, 2025

More Information

Terms related to this study

• Keywords: pulmonary function; postoperative pain; plane block
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Postoperative Complications; Pathologic Processes; Pain, Postoperative
• Other Study ID Numbers: 2023/04-3

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No