{
  "abstract": "Application for ESRA Abstract Prizes:Background and Aims Unplanned conversion from laparoscopic to open liver surgery presents significant challenges in postoperative pain management. The external oblique intercostal (EIO) plane block has emerged as a promising technique for upper abdominal wall analgesia. We present a case of successful pain management using continuous EOI plane block following unplanned conversion to open liver resection.Methods A 69-year-old ASA III male with metastatic colorectal cancer required conversion to open subcostal liver resection after intraoperative bleeding compromised the laparoscopic approach. Intraoperative analgesia included paracetamol, tramadol, parecoxib and morphine (total of 3 mg). Postoperatively, we performed an ultrasound-guided EOI plane block at the right sixth rib (transverse orientation, linear probe) using 20 mL of 0.2% ropivacaine. A catheter was placed for administration of 0.1% ropivacaine via programmed intermittent bolus (10 mL/hour) with patient-controlled boluses (10 mL, 30-minute lockout). Intravenous adjuncts included paracetamol (1 g 6/6 h), parecoxib (40 mg 12/12 h), and rescue morphine.Results The patient was extubated uneventfully and transferred to the ICU. He maintained optimal pain control throughout recovery, reporting only mild incisional pain at maximum intensity while requiring no supplemental opioids after the first 24 hours. The perineural catheter was removed on postoperative day 2. The patient achieved progressive recovery of autonomy and was discharged on day 4.Conclusions The continuous EIO plane block provided effective analgesia, avoiding the need for neuraxial approaches in the postoperative period or prolonged opioid use. This technique may be a viable alternative for unplanned open liver surgery, but more evidence is needed to validate its efficacy in complex abdominal procedures.",
  "authors": [
    {
      "affiliations": [
        "Serviço de Anestesiologia, Unidade Local de Saúde Trás-os-Montes e Alto Douro, Vila Real, Portugal"
      ],
      "name": "Erica Amaral"
    },
    {
      "affiliations": [
        "Serviço de Anestesiologia, Unidade Local de Saúde Trás-os-Montes e Alto Douro, Vila Real, Portugal"
      ],
      "name": "Ana Rita Rocha"
    },
    {
      "affiliations": [
        "Serviço de Anestesiologia, Unidade Local de Saúde Trás-os-Montes e Alto Douro, Vila Real, Portugal"
      ],
      "name": "Beatriz Xavier"
    },
    {
      "affiliations": [
        "Serviço de Anestesiologia, Unidade Local de Saúde Trás-os-Montes e Alto Douro, Vila Real, Portugal"
      ],
      "name": "Francisco Teixeira"
    },
    {
      "affiliations": [
        "Serviço de Anestesiologia, Unidade Local de Saúde Trás-os-Montes e Alto Douro, Vila Real, Portugal"
      ],
      "name": "Miguel Sá"
    },
    {
      "affiliations": [
        "Serviço de Anestesiologia, Unidade Local de Saúde Trás-os-Montes e Alto Douro, Vila Real, Portugal"
      ],
      "name": "Franscisco Seixas"
    },
    {
      "affiliations": [
        "Serviço de Anestesiologia, Unidade Local de Saúde Trás-os-Montes e Alto Douro, Vila Real, Portugal"
      ],
      "name": "Susana Caramelo"
    }
  ],
  "title": "P312 Continuous external oblique intercostal plane block as part of multimodal analgesia for unplanned open liver surgery – a case report",
  "uid": "0d560ba8-92a2-52d7-931b-0bc5c3e76897"
}