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Background and Aims External oblique intercostal plane block is a novel technique which targets lateral and anterior cutaneous branches of intercostal nerves from T6-T10 through a single injection. We conducted this RCT to study analgesic efficacy of ultrasound-guided External Oblique Intercostal Plane Block in pediatric patients undergoing upper abdominal surgeries.To evaluate efficacy of ultrasound-guided External Oblique Intercostal Plane Block in pediatric patients undergoing upper abdominal surgeriesMethods This is a double-blind randomized controlled trial on pediatric patients (2 months to 7 years), ASA I and II, scheduled for upper abdominal surgeries with unilateral incisions. US-guided EOI plane block was given to all patients in group I. Any increase in HR/MAP by more than 20% intraoperatively was treated with additional fentanyl doses of 1 mcg/k and total intraoperative fentanyl consumption was noted in both groups. Intraoperatively, MAP and HR were recorded at 5, 30, 60, and 90 minutes. Pain was assessed using FLACC scale at 1, 4, 8, 16, and 24 hours and Injection Tramadol 1 mg/kg IV was given as rescue analgesia if FLACC score ≥4, and time was noted.Results A significant difference was noted in total intraoperative fentanyl consumption, time to first rescue analgesia, and FLACC scale at 1, 4, 8, and 24 hours postoperatively.Conclusions Reduction in pain scores, decreased reliance on systemic analgesics collectively highlight effectiveness of ultrasound-guided EOI block as a valuable regional anesthesia technique for managing perioperative pain in pediatric upper abdominal surgeries