{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T11:24:56Z","timestamp":1788175496631,"version":"build-2803163510"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T00:00:00Z","timestamp":1752105600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>Regional techniques are preferred for controlling post-thoracotomy pain due to lower complication rates. This study aimed to compare the analgesic efficacy and safety of ultrasound-guided external oblique intercostal block (EOIB) with thoracic erector spinae plane block (ESPB) for post-thoracotomy pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This randomised, double-blind, non-inferior clinical study involved 60 cases scheduled for thoracic surgery. Cases were randomly allocated into two groups: ESPB and EOIB groups. Using 30 mL 0.25% bupivacaine at the level of the thoracic vertebrae 5, both blocks were performed after induction of general anaesthesia. The primary outcome was morphine consumption in the first 24 hours postoperatively. The secondary outcomes were time to first rescue analgesic request postoperatively, numerical rating scale (NRS) score during rest and with coughing, and occurrence of complications. The non-parametric Wilcoxon test was used for non-normally distributed variables, the Student\u2019s\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      -test was used for normally distributed variables, and the Chi-square\/Fisher\u2019s exact test was used for qualitative variables. The significance level was set at\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2264 0.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Patients who required intraoperative fentanyl, time of first request for analgesia, total morphine consumption, and pain score within the first 24 hours post-surgery were comparable between the two groups (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.347, 0.085, and 0.354, respectively). Both groups exhibited comparable incidences of hypotension and bradycardia (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.353 and\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.99, respectively). Local anaesthetic systemic toxicity (LAST) and pneumothorax did not occur in any patient in either group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The analgesic effect of EOIB was non-inferior to ESPB for post-thoracotomy pain, as evidenced by comparable total opioid consumption, time of first request for analgesia, and pain score in the first 24 hours post-surgery. Additionally, EOIB demonstrated the same level of safety as ESPB.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ija.ija_3_25","type":"journal-article","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T10:00:21Z","timestamp":1752141621000},"page":"809-815","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Ultrasound-guided external oblique intercostal plane block versus thoracic erector spinae block for post-thoracotomy pain: A randomised double-blinded non-inferior clinical study"],"prefix":"10.4103","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1364-4679","authenticated-orcid":false,"given":"Saad A.","family":"Moharam","sequence":"first","affiliation":[{"name":"Anesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0814-6728","authenticated-orcid":false,"given":"Mohammed S.","family":"ElSharkawy","sequence":"additional","affiliation":[{"name":"Anesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2329-8968","authenticated-orcid":false,"given":"Mhmoud A.","family":"Almohasseb","sequence":"additional","affiliation":[{"name":"Anesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8951-497X","authenticated-orcid":false,"given":"Khaled","family":"Hamama","sequence":"additional","affiliation":[{"name":"Anesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1282-5628","authenticated-orcid":false,"given":"Mohamed A.","family":"Mahmoud","sequence":"additional","affiliation":[{"name":"Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Assiut, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6634-7379","authenticated-orcid":false,"given":"Marwa A.","family":"Abogabal","sequence":"additional","affiliation":[{"name":"Anesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,7,10]]},"reference":[{"key":"R1-20260421","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.bjae.2023.05.001","article-title":"Regional analgesia for acute pain relief after open thoracotomy and video-assisted thoracoscopic surgery","volume":"23","author":"Mehta","year":"2023","journal-title":"BJA Educ"},{"key":"R2-20260421","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.mpaic.2023.11.001","article-title":"Analgesia for thoracic surgery","volume":"25","author":"Oram","year":"2024","journal-title":"Anaesth Intensive Care Med"},{"key":"R3-20260421","doi-asserted-by":"crossref","first-page":"2287","DOI":"10.2147\/JPR.S144066","article-title":"Poorly controlled postoperative pain: Prevalence, consequences, and prevention","volume":"10","author":"Gan","year":"2017","journal-title":"J Pain Res"},{"key":"R4-20260421","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1097\/00002508-199603000-00009","article-title":"Acute pain after thoracic surgery predicts long-term post-thoracotomy pain","volume":"12","author":"Katz","year":"1996","journal-title":"Clin J Pain"},{"key":"R5-20260421","doi-asserted-by":"crossref","first-page":"2421","DOI":"10.1053\/j.jvca.2020.01.026","article-title":"Ultrasound-guided erector spinae plane block versus intercostal nerve block for post-minithoracotomy acute pain management: A randomized controlled trial","volume":"34","author":"Fiorelli","year":"2020","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"R6-20260421","doi-asserted-by":"crossref","first-page":"2276","DOI":"10.21037\/jtd-21-1740","article-title":"Regional anesthesia and acute perioperative pain management in thoracic surgery: A narrative review","volume":"14","author":"Hamilton","year":"2022","journal-title":"J Thorac Dis"},{"key":"R7-20260421","first-page":"149","article-title":"PROSPECT: Evidence-based, procedure-specific postoperative pain management","volume":"21","author":"Kehlet","year":"2007","journal-title":"Best Pract Res Clin Anaesthesiol"},{"key":"R8-20260421","doi-asserted-by":"crossref","first-page":"S2223","DOI":"10.21037\/jtd.2018.06.117","article-title":"Epidural for mini-invasive thoracic surgery: Do we need a sledgehammer to crack a nut?","volume":"10","author":"Umari","year":"2018","journal-title":"J Thorac Dis"},{"key":"R9-20260421","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1097\/AAP.0000000000000451","article-title":"The erector spinae plane block: A novel analgesic technique in thoracic neuropathic pain","volume":"41","author":"Forero","year":"2016","journal-title":"Reg Anesth Pain Med"},{"key":"R10-20260421","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/j.sjpain.2017.08.013","article-title":"Erector spinae plane (ESP) block in the management of post thoracotomy pain syndrome: A case series","volume":"17","author":"Forero","year":"2017","journal-title":"Scand J Pain"},{"key":"R11-20260421","first-page":"e8988","article-title":"Utilization of erector spinae plane block in the chronic pain clinic for two patients with post-thoracotomy pain","volume":"12","author":"Hasoon","year":"2020","journal-title":"Cureus"},{"key":"R12-20260421","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1186\/s42077-020-00083-w","article-title":"Ultrasound-guided erector spinae block for postoperative analgesia in thoracotomy patients: A prospective, randomized, observer-blind, controlled clinical trial","volume":"12","author":"Sobhy","year":"2020","journal-title":"Ain Shams J Anesthesiol"},{"key":"R13-20260421","doi-asserted-by":"crossref","first-page":"2436","DOI":"10.1093\/pm\/pnab296","article-title":"The external oblique intercostal block: Anatomic evaluation and case series","volume":"22","author":"Elsharkawy","year":"2021","journal-title":"Pain Med"},{"key":"R14-20260421","first-page":"504","volume":"68","author":"Mistry","year":"2024","journal-title":"External oblique intercostal plane block: Anatomical landmark-guided technique! Indian J Anaesth"},{"key":"R15-20260421","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s42077-020-00083-w","article-title":"Ultrasound-guided erector spinae block for postoperative analgesia in thoracotomy patients: A prospective, randomized, observer-blind, controlled clinical trial","volume":"12","author":"Sobhy","year":"2020","journal-title":"Ain Shams J Anesthesiol"},{"key":"R16-20260421","doi-asserted-by":"crossref","first-page":"678","DOI":"10.4103\/joacp.JOACP_657_20","article-title":"Motor block and hypotension following a high thoracic erector spinae plane block","volume":"38","author":"Kumar","year":"2022","journal-title":"J Anaesthesiol Clin Pharmacol"},{"key":"R17-20260421","doi-asserted-by":"crossref","first-page":"Np46","DOI":"10.1177\/0300891620912024","article-title":"Ultrasound-guided erector spinae block for post-thoracotomy pain syndrome in video-assisted thoracic surgery","volume":"106","author":"Piraccini","year":"2020","journal-title":"Tumori"},{"key":"R18-20260421","doi-asserted-by":"crossref","first-page":"709","DOI":"10.2147\/JPR.S248171","article-title":"Bilateral erector spinae plane blocks for open posterior lumbar surgery","volume":"13","author":"Zhang","year":"2020","journal-title":"J Pain Res"},{"key":"R19-20260421","first-page":"101161","article-title":"Erector spinae plane block versus subcostal transversus abdominis plane block in patients undergoing open liver resection surgery: A randomized controlled trial","volume":"42","author":"Mostafa","year":"2023","journal-title":"Anaesth Crit Care Pain Med"},{"key":"R20-20260421","first-page":"e30069","article-title":"Erector spinae plane catheter for postoperative thoracotomy Pain in a patient with indwelling spinal cord stimulators: A case report","volume":"14","author":"Cheng","year":"2022","journal-title":"Cureus"},{"key":"R21-20260421","doi-asserted-by":"crossref","first-page":"174","DOI":"10.21037\/atm.2019.03.53","article-title":"Ultrasound-guided preoperative single-dose erector spinae plane block provides comparable analgesia to thoracic paravertebral block following thoracotomy: A single centre randomised controlled, double-blind study","volume":"7","author":"Fang","year":"2019","journal-title":"Ann Transl Med"},{"key":"R22-20260421","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1097\/AAP.0000000000000838","article-title":"Is a thoracic fascial plane block the answer to upper abdominal wall analgesia?","volume":"43","author":"Hamilton","year":"2018","journal-title":"Reg Anesth Pain Med"},{"key":"R23-20260421","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.jclinane.2018.10.015","article-title":"Perichondral approach for blockage of thoracoabdominal nerves: Anatomical basis and clinical experience in three cases","volume":"54","author":"Tulgar","year":"2019","journal-title":"J Clin Anesth"},{"key":"R24-20260421","doi-asserted-by":"crossref","DOI":"10.1136\/rapm-2023-104510","article-title":"Postoperative analgesia for Kasai portoenterostomy using external oblique intercostal blocks","author":"Wilkinson-Maitland","year":"2023","journal-title":"Reg Anesth Pain Med"},{"key":"R25-20260421","doi-asserted-by":"crossref","first-page":"e12225","DOI":"10.1002\/anr3.12225","article-title":"External oblique intercostal (EOI) block for enhanced recovery after liver surgery: A case series","volume":"11","author":"Liotiri","year":"2023","journal-title":"Anaesth Rep"},{"key":"R26-20260421","doi-asserted-by":"crossref","DOI":"10.1136\/rapm-2018-100256","article-title":"External oblique fascial plane block","author":"Hamilton","year":"2019","journal-title":"Reg Anesth Pain Med"},{"key":"R27-20260421","doi-asserted-by":"crossref","first-page":"e295","DOI":"10.1016\/j.bja.2022.02.011","article-title":"External oblique intercostal plane block for upper abdominal surgery: Use in obese patients","volume":"128","author":"White","year":"2022","journal-title":"Br J Anaesth"},{"key":"R28-20260421","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1097\/AAP.0000000000000349","article-title":"Quadratus lumborum block: Analgesic effects and chronological ropivacaine concentrations after laparoscopic surgery","volume":"41","author":"Murouchi","year":"2016","journal-title":"Reg Anesth Pain Med"},{"key":"R29-20260421","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1213\/XAA.0000000000000605","article-title":"Bilateral continuous erector spinae plane block contributes to effective postoperative analgesia after major open abdominal surgery: A case report","volume":"9","author":"Restrepo-Garces","year":"2017","journal-title":"A A Case Rep"},{"key":"R30-20260421","first-page":"e39139","article-title":"External oblique intercostal block for living kidney donor open nephrectomy: A case series","volume":"15","author":"Petiz","year":"2023","journal-title":"Cureus"},{"key":"R31-20260421","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.15537\/smj.2023.44.10.20230350","article-title":"Bilateral external oblique intercostal plane block (EOIPB) in patients undergoing laparoscopic cholecystectomy: A randomized controlled trial","volume":"44","author":"Korkusuz","year":"2023","journal-title":"Saudi Med J"},{"key":"R32-20260421","first-page":"A106","article-title":"EP125 Evaluation of ultrasound-guided external oblique intercostal plane block for postoperative analgesia in laparoscopic cholecystectomy: A prospective, randomized, controlled clinical trial","volume":"48","author":"Kusderci","year":"2023","journal-title":"Reg Anesth Pain Med"},{"key":"R33-20260421","first-page":"A19","article-title":"OP033 Analgesic efficacy of external oblique intercostal plane block in pediatric patients undergoing upper abdominal surgeries: A case series","volume":"48","author":"Shrey","year":"2023","journal-title":"Reg Anesth Pain Med"},{"key":"R34-20260421","doi-asserted-by":"crossref","first-page":"209","DOI":"10.17245\/jdapm.2019.19.4.209","article-title":"An in vivo study comparing efficacy of 0.25% and 0.5% bupivacaine in infraorbital nerve block for postoperative analgesia","volume":"19","author":"Saha","year":"2019","journal-title":"J Dent Anesth Pain Med"},{"key":"R35-20260421","doi-asserted-by":"crossref","first-page":"7","DOI":"10.59204\/2314-6788.3288","article-title":"Postoperative analgesic efficacy of high versus low volume of bupivacaine in ultrasound-guided quadratus lumborum block","volume":"37","author":"Abdallah","year":"2024","journal-title":"Menoufia Med J"},{"key":"R36-20260421","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/s12871-023-02004-4","article-title":"Comparison of analgesic efficacy of different local anesthetic volumes for erector spinae plane block in thoracotomy patients; A prospective randomized trial","volume":"23","author":"Zengin","year":"2023","journal-title":"BMC Anesthesiol"},{"key":"R37-20260421","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1007\/s00586-019-06133-8","article-title":"Opioid-sparing multimodal analgesia with bilateral bi-level erector spinae plane blocks in scoliosis surgery: A case report of two patients","volume":"29","author":"Chin","year":"2020","journal-title":"Eur Spine J"}],"container-title":["Indian Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ija.ija_3_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:00:50Z","timestamp":1786647650000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ija.ija_3_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,10]]},"references-count":37,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/ija.ija_3_25","relation":{},"ISSN":["0019-5049","0976-2817"],"issn-type":[{"value":"0019-5049","type":"print"},{"value":"0976-2817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,10]]},"assertion":[{"value":"2025-01-01","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-28","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}