Clinical trial NCT06519708: Analgesic Efficacy of Erector Spinae Plane Block vs External Oblique Intercostal Plane Block in Subcostal Cancer Surgeries
Official title: Analgesic Efficacy of Erector Spinae Plane Block vs External Oblique Intercostal Plane Block in Subcostal Cancer Surgeries: A Randomized Controlled Study
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Analgesia
Erector Spinae Plane Block
External Oblique Intercostal Plane Block
Subcostal Cancer Surgeries
Lead sponsor: National Cancer Institute, Egypt
Sponsor class: OTHER
First posted: 2024-07-25
Enrollment: 70
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: This study aims to evaluate the impact of ultrasound-guided erector spinae plane block compared to ultrasound-guided external oblique intercostal plane block regarding management of postoperative acute pain in patients undergoing above Umbilical surgical procedure.

Detailed description: Subcostal incisions in cancer surgeries as in hepatectomy and nephrectomy are a cause of severe pain and can lead to significant respiratory impairment. Regional anesthesia of the trunk and abdominal wall is usually centered on epidural analgesia.

Erector spinae plane block (ESPB) is the deposition of local anesthetic (LA) in the interfascial plane at the paraspinal region. It provides effective visceral and somatic analgesia.

The recently described external oblique intercostal plane block (EOIPB) is a simple, effective, and convenient block, particularly in the context of morbid obesity, at which local anesthetic (LA) is deposited in the interfacial plane deep to external oblique muscle at the sixth intercostal space. It provides a blockade of the thoracoabdominal nerves at the level of T6 to T10.

Eligibility criteria: Inclusion Criteria:

* Age (18-65) Years.
* Both sexes.
* Body mass index (BMI): (20-40) kg/m2.
* American Society of Anesthesiology (ASA) physical status II, III.
* Type of surgery; unilateral subcostal incision in hepatectomy and nephrectomy.

Exclusion Criteria:

* Patient refusal.
* Subcostal incisions that are crossing the midline or midline incision.
* Age \<18 years or \>65 years
* BMI \<20 kg/m2 and \>40 kg/m2
* Known sensitivity or contraindication to drugs used in the study
* Contraindication to regional anesthesia e.g. local infection at the site of introduction, pre-existing peripheral neuropathies, and coagulopathy.
* Pregnancy.
* Physical status ASA IV
* patients on chronic analgesic therapy (daily morphine ≥30 mg or equivalent dose of other opioids or tramadol or any medication for neuropathic pain)
* patients with a history of drug abuse
* patients with neuropsychiatric diseases; patients with a history of chronic pain syndromes that may enhance sensitivity to pain, for example, fibromyalgia
* All patients who are going to have severe intra- or post-operative bleeding or will require postoperative mechanical ventilation are also excluded from the study.

Primary outcomes:
measure: Total amount of morphine consumption
timeFrame: 24 hours postoperatively
Secondary outcomes:
measure: Total amount of intraoperative fentanyl consumption
timeFrame: Intraoperatively
measure: Heart rate
timeFrame: Till the end of surgery
measure: Mean arterial blood pressure
timeFrame: Till the end of surgery
measure: Time of first rescue analgesia
timeFrame: 24 hours postoperatively
measure: Complications
timeFrame: 24 hours postoperatively
measure: Patient satisfaction
timeFrame: 24 hours postoperatively
Other outcomes:
Locations:
city: Cairo
country: Egypt
facility: Cairo University
Study officials:
References: