A Comparative Study Between Ultrasound Guided External Oblique Intercostal Plane (EOIP) Block and Erector Spinae Plane (ESP) Block for Postoperative Analgesia in Upper Abdominal Surgeries

Study Overview
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Brief Summary
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Upper abdominal incisions, such as the oblique subcostal laparotomy, can cause severe pain and can lead to significant respiratory impairment. Erector spinae plane (ESP) block is the deposition of local anaesthetic (LA) in the interfascial plane at the paraspinal region. It provides effective visceral and somatic analgesia. External oblique intercostal plane (EOIP) block is a newly described block at which local anaesthetic (LA) is deposited in the interfascial plane deep to external oblique muscle at the sixth intercostal space. It provides blockade of the thoracoabdominal nerves at the level of T6 to T10. In this study, the investigators compare between ultrasound (US) guided external oblique intercostal plane block and erector spinae plane block, in providing postoperative analgesia for upper abdominal surgeries

Official Title
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A Comparative Study Between Ultrasound Guided External Oblique Intercostal Plane (EOIP) Block and Erector Spinae Plane (ESP) Block for Postoperative Analgesia in Upper Abdominal Surgeries

Conditions
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Block

Intervention / Treatment
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* Procedure: external oblique intercostal plane block
* Procedure: erector spinae plane block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with American Society of Anesthesiologists physical status (ASA) I and II. Both sex. 20 to 60 years old patients. upper abdominal surgeries. Exclusion Criteria: Refusal of the patient to consent. Patients with ASA status III or IV Patients with bleeding disorders and coagulopathy (INR≥1.6 & PTT≥50 sec). Infection at the injection site. Allergy to local anesthetics. Patients with ages less than 20 or more than 60 Patients with pre-existing myopathy or neuropathy. Patients with chronic pain syndromes. Patients with history of long acting opioids or steroids preoperatively.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: external oblique intercostal plane block<br> | Procedure: external oblique intercostal plane block<br>* o EOIP Group (ŋ=25): Patients will receive ultrasound guided External oblique intercostal plane block with 20 ml of LA mixture (10 mL of bupivacaine 0.5%, 5 mL of lidocaine 2% and 5 mL of normal saline to make a total volume of 20 ml.) at the end of procedure, unilaterally or bilaterally according to the surgery.<br>|
| Active Comparator: erector spinae plane block<br> | Procedure: erector spinae plane block<br>* o ESP Group (ŋ=25): Patients will receive ultrasound guided Erector spinae plane block with 20 ml of LA mixture (10 mL of bupivacaine 0.5%, 5 mL of lidocaine 2% and 5 mL of normal saline to make a total volume of 20 ml.) at the end of procedure, unilaterally or bilaterally according to the surgery.<br>|
| No Intervention: control group<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| amount of total 24 hour pethidine consumption (mg) . | to measure total 24 hour pethidine consumption postoperatively. | 24 hours postoperatively | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| visual analogue scale (VAS) at rest and movement. | recorded postoperative immediately and 2, 4, 6, 8, 12, 18 and 24 hours. The Visual Analogue Scale (VAS) measures pain intensity. The visual analogue scale (VAS) consists of a 10 cm line, with two end points representing 0 (no pain) and 10 (pain as bad as it could possibly be). | 24 hours postoperatively | 
| mean arterial blood pressure (MAP) | recorded postoperative immediately and 2, 4, 6, 8, 12, 18 and 24 hours | 24 hours postoperatively | 
| heart rate (HR) | recorded postoperative immediately and 2, 4, 6, 8, 12, 18 and 24 hours | 24 hours postoperatively | 
| incidence of postoperative complications (nausea and vomiting) | recorded postoperative immediately and 2, 4, 6, 8, 12, 18 and 24 hours | 24 hours postoperatively | 
| time to start mobilization | recorded postoperative immediately and 2, 4, 6, 8, 12, 18 and 24 hours | 24 hours postoperatively |