Rhomboid intercostal and sub serratus plane block for post-operative analgesia after laparoscopic cholecystectomy: a randomized control study

Abstract

Abstract Background: The "Rhomboid intercostal and subserratus plane" block (RISS) is a relatively new block technique that proved its efficacy in different thoracic procedures. Nonetheless, its role in laparoscopic cholecystectomy is undervaluated. We conducted this study to evaluate the effectiveness of RISS block in providing and maintaining postoperative analgesia in patients undergoing laparoscopic cholecystectomy. Methodology: This prospective trial included 90 patients who were randomly divided into two groups: the RISS group that received the block (n = 45) and the control group that received no block (n = 45). Results: Baseline demographic parameters and the operative time did not differ between the two groups (P ˃ 0.05). The RISS group had a significantly better intraoperative hemodynamic profile, manifested by the decreased heart rate and arterial pressure measurements compared to controls (P ˂ 0.05). Lower pain scores were encountered in the RISS group during the initial 12 hours after the operation (P ˂ 0.05). Additionally, The RISS led to significant prolongation in the time to the first rescue analgesia (729.11 vs. 23.89 minutes, respectively) and Postoperative fentanyl consumption was markedly decreased (45.11 vs. 153.24 mcg, respectively) compared to controls (both P ˂ 0.05). Subsequently, patient satisfaction showed better improvement when the RISS was used (P ˂ 0.05). Conclusion: Bilateral RISS block is an effective option to provide post-operative analgesia for patients undergoing laparoscopic cholecystectomy. It should be performed as a part of a multimodal analgesia.