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$sth->bind_param(1, $value, ... );
$sth->bind_param( 2, $value, ... );

my $sql = "INSERT INTO sometable (x, y, z, blobby) VALUES (?, ?, ?, ?)
+"

...
$sth->bind_param( 4, $lob_value, { ora_type => ORA_BLOB });

$sth->execute();