External Oblique Intercostal Block Catheters for Liver Transplant Postoperative Pain Management
A Retrospective Study

Ashton Pike, Austin Peters, Nathalie Lunden, Carolyn Heeder, Ryan Ivie

INTRO

• Regional pain management in liver transplants remains difficult due to

inherent coagulopathy and limitations of existing block techniques

• This study evaluates the impact of external oblique intercostal (EOI)

catheter blocks on postoperative opioid consumption in liver transplant

patients

METHODS

• Single center, retrospective study

• N=32, 16 in block group, 16 non-blocked group

• ASA 4E, liver transplant, > 18 years old

• Primary outcome of morphine milligram equivalent (MME) consumption

measured at 24, 48, 72, and 96 hour intervals and cumulative MME

consumption to 96 hour

• Secondary outcomes included dermatomal coverage, block related

complications, ambulation and hospitalization times, pain scores from

post-operative day 1-7

• Approved through institution’s IRB protocol

RESULTS

• Reduction in total MME consumption in blocked patients compared to

non-blocked patients

• Pain scores, ambulation times, extubation times, and hospitalization

times did not differ significantly between groups,

• Block coverage extended from T5 to T9 dermatomes

• No block complications, including bleeding or local anesthetic toxicity

DISCUSSION

• External oblique intercostal block in liver transplant patients significantly

reduces MME consumption at the 72 hour postoperative window with

absolute reductions in MME values over a 96 hour window

• The block provides consistent somatic pain coverage along lateral and

anterior aspects of T5-9 dermatomes of anterolateral upper abdomen.

A  longitudinal model was used to estimate the effect of the block at each timepoint: