Bilateral External Oblique Block with Catheter Insitu for Post Operative Pain Management of Exploratory Laparotomy

Dr. Yogeshwari, Dr. Archita Patil, Dr. Sandeep Kadam, Dr. Akshath Goklani

Abstract: Materials and methods: Study design: Case report. We report a case of 62 year old male diagnosed with gastric carcinoma posted for gastrojejunostomy and jejunojejunostomy. Thorough preoperative evaluation was done prior to surgery. On examination MPC grade 3, upper and lower incisors absent. Case was managed by routine anaesthesia protocol with general anaesthesia and after induction bilateral 18 G epidural catheters were placed in external oblique fascial plane under USG guidance at 6th intercostal space. Patient was hemodynamically stable with adequate analgesia intraoperatively and no requirement of NSAIDs or opioids use postoperatively. Result: Patient had good pain relief post op with top ups given with Inj. Bupivacaine 0.125% 15cc on each side every 12th hourly. Patient received 2 doses of Inj. Paracetamol 1gm intravenously on post op day zero and 1 dose on post op day 1 and 2. Conclusion: Pain control following laparotomy can be difficult to manage. A feasible option for pain control may be bilateral external oblique catheter. Future studies are required to determine the effectiveness of external oblique nerve catheter.

Keywords: Upper abdominal surgeries, external oblique catheter, postoperative pain management, ultrasound-guided analgesia, opioid-sparing technique