Comparative effectiveness of TAP block, EOIP block, and standard care for postoperative analgesia in renal transplantation: a retrospective study

Background: Effective pain management following renal transplantation is crucial. While various regional analgesic techniques have been studied, the optimal approach remains unclear. We compared the additive value of Transversus Abdominis Plane (TAP) and External Oblique Intercostal Plane (EOIP) blocks to Standard Care (SC) on postoperative pain and opioid consumption. Methods: This retrospective study included 237 renal transplant recipients (127 SC, 75 TAP, 35 EOIP) between January 2023 and December 2024. Multivariable regression analysis assessed the association of block type on postoperative pain and opioid consumption. Results: TAP block was associated with significantly lower pain scores than SC during the first eight postoperative hours (5.0 vs. 7.0, p < 0.001). Pre-incision TAP block demonstrated the most significant reduction in both pain scores (β = -2.21, 95% CI -3.38 to -1.05, p < 0.001) and opioid consumption (β = -13.56, 95% CI: -21.59 to -5.52, p = 0.001). EOIP block showed no significant advantages over SC and was associated with higher opioid consumption compared to TAP block. Conclusion: Pain predominantly manifested in the first eight postoperative hours. TAP block, particularly when administered pre-incision, was associated with superior pain control compared to SC or EOIP block. Living donor recipients experienced significantly higher pain scores regardless of technique, warranting further investigation.