Sensory Analysis and Cutaneous Mapping of Different Regional Anesthesia Techniques

Официальное название

Sensory Analysis and Cutaneous Mapping of Different Regional Anesthesia Techniques in Laparoscopic Cholecystectomy Surgery: A Prospective Observational Study

Обзор

This prospective observational study aims to evaluate and compare the sensory block distribution and regression patterns of two regional anesthesia techniques - External Oblique Plane Block (EOPB) and Serratus Intercostal Plane Block (SIPB) - in patients undergoing laparoscopic cholecystectomy. Thirty adult patients (ASA I-III, BMI ≤ 35 kg/m², ≥50 kg) scheduled for elective laparoscopic cholecystectomy procedures will be included, with 20 in each block group. Sensory block areas will be assessed using pinprick test, and dermatomal mapping will visualize the spread. The findings are expected to improve understanding of block behavior and guide multimodal analgesia strategies in laparoscopic cholecystectomy.

Подробное описание

This single-center, prospective observational study will be conducted at Samsun University Training and Research Hospital operating rooms between November 2025 and June 2026.

The study will include patients aged 18-75 years, classified as ASA I-III, who are scheduled for elective laparoscopic cholecystectomy and have provided written informed consent. For pain management, these patients will undergo either serratus intercostal plane block (SIPB) or external oblique plane block (EOPB) under ultrasound guidance. Patients receiving one of these two block techniques will be observed, and the sensory block areas created will be evaluated.

Both blocks will be performed bilaterally and under ultrasound guidance immediately before surgery. 0.25% bupivacaine will be used for the block applications, and 25 mL of local anesthetic will be injected into each side (a total of 50 mL). Thirty minutes after the block, patients will be evaluated for cutaneous sensory block using the "pinprick test." This evaluation will be standardized according to specific dermatome levels, covering the midline and both abdominal quadrants, in order to describe sensory loss on the skin.

The data obtained will be analyzed to determine the dermatomal spread and the minimum and maximum areas of effect of the blocks. Additionally, findings related to block application time will be recorded observationally. A comparison between the groups will be made, and the degree of overlap between the sensory block areas and the surgical incision site will be evaluated.

Вмешательства

• Процедура External Oblique Plane Block (EOPB)
  Ultrasound-guided External Oblique Plane Block (EOPB) performed bilaterally using 0.25% bupivacaine (25 mL per side, total 50 mL) for postoperative analgesia in laparoscopic cholecystectomy.
• Процедура Serratus Intercostal Plane Block (SIPB)
  Ultrasound-guided Serratus Intercostal Plane Block (SIPB) performed bilaterally using 0.25% bupivacaine (25 mL per side, total 50 mL) for postoperative analgesia in laparoscopic cholecystectomy.

Первичные конечные точки

• Cutaneous Sensory Block Area of EOPB and SIPB [Срок оценки: 30 minutes after block application]

Вторичные конечные точки (3)

• Coverage of Surgical Port Entry Sites by the Sensory Block Area [Срок оценки: 30 minutes after block application]
• Maximum and Minimum Spread of the Cutaneous Sensory Block Area [Срок оценки: 30 minutes after block application]
• Block Application Duration [Срок оценки: From needle insertion to completion of local anesthetic injection]

Критерии участия

Критерии включения

• Patients scheduled for elective laparoscopic cholecystectomy surgery and who have received a regional anesthesia technique for this purpose.
• Aged between 18-75 years.
• Belonging to ASA I-III group.
• Having provided written informed consent.

Критерии исключения

• Patients who refuse to participate.
• Patients who did not receive a block.
• Patients classified as ASA IV.
• History of previous abdominal surgery (affecting the laparoscopic approach).
• Patients with cognitive dysfunction or inability to cooperate.
• Patients diagnosed with psychiatric disorders (schizophrenia, mania, depression, etc.).
• Patients who have been using antipsychotic medication for more than 4 weeks.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Модель наблюдения

Когортное

Центры проведения

Turkey (Türkiye) · 1 центр

• Samsun University, Samsun Training and Research Hospital — Samsun

Публикации

• Nielsen TD, Moriggl B, Barckman J, Kolsen-Petersen JA, Soballe K, Borglum J, Bendtsen TF. The Lateral Femoral Cutaneous Nerve: Description of the Sensory Territory and a Novel Ultrasound-Guided Nerve Block Technique. Reg Anesth Pain Med. 2018 May;43(4):357-366. doi: 10.1097/AAP.0000000000000737. PMID 29381568
• Dost B, Turunc E, Kaya C, Sahin CA, Genc C, Yucel SM, Demirag MK, Karakaya D. Maximum extension and regression rate of cutaneous sensory block: superficial vs. deep parasternal intercostal plane blocks in patients undergoing open cardiac surgery. J Clin Anesth. 2025 Jul;105:111888. doi: 10.1016/j.jclinane.2025.111888. Epub 2025 May 30. PMID 40449315
• Genc C, Tulgar S, Akgun C, Avci MA, Yesilyurt B, Yildiz B, DE Cassai A. Maximum extension and regression rate of cutaneous sensory block obtained with the external oblique intercostal block or the modified thoracoabdominal nerves block through perichondrial approach in patients undergoing laparoscopic cholecystectomy. Minerva Anestesiol. 2024 Nov;90(11):979-988. doi: 10.23736/S0375-9393.24.18213-2 PMID 39545654

Идентификаторы

NCT: NCT07445854 · GOKAEK 2025/20/13

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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