Clinical trial NCT06822309: Bilateral External Oblique Intercostal Plane Block in Post Operative Pain Management in Hepatectomy
Official title: Bilateral External Oblique Intercostal Plane Block Versus Patient Controlled Analgesia (PCA) in Post Operative Pain Management in Hepatectomy Surgery.
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: NA
Conditions: Provide Post Hepatectomy Pain Control
Keywords: External Oblique Intercostal block
subcostal incision
hepatectomy
Patient control analgesia
Lead sponsor: Kasr El Aini Hospital
Sponsor class: OTHER
First posted: 2025-02-12
Enrollment: 40
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: SUPPORTIVE_CARE

Brief summary: The majority of cases undergoing hepatectomy suffer from inadequate postoperative analgesia. Therefore, multimodal analgesic techniques are required to relieve pain and discomfort such as intravenous, and epidural analgesia, and peripheral nerve blocks. Although epidural catheters are efficient to provide perioperative analgesia, in this type of surgery patients may be more susceptible to catheter related complications due to the alteration in coagulation parameters. That is why safer alternatives are sought for those patients. The use of patient-controlled analgesia (PCA) for postoperative pain management improves patients' quality of recovery. However, there are many concerns regarding the type of opioids used in PCA such as overdosing, underdosing, and the effect of the hepatectomy on the drug metabolism in those patients. External oblique intercostal plane block (EOI block) is a relatively novel block used in upper abdominal incisions especially subcostal laparotomy to provide intraoperative and postoperative analgesia.

This study aims to compare the efficacy of Bilateral External Oblique Intercostal Plain Block versus PCA in pain management and reduction of opioid use in hepatectomy surgery done by subcostal incision.


Eligibility criteria: Inclusion Criteria:

* Age ≥ 18 and ≤ 65 Years.
* Both sexes.
* Patients will be scheduled for hepatectomy surgery.
* Body mass index (BMI) 18.5-30.0 /m 2 .

Exclusion Criteria:

* Extension of the surgical incision beyond coverage of T12 dermatome.
* Prolonged time of surgery \&gt; 5 hours.
* Hepatectomy surgery combined with another organ resection.
* Patients with hypersensitivity to local anesthetics.
* History of psychiatric problems.
* Recent history of analgesic drugs including opioid abuse or addiction.
* Coagulopathy (International normalized ratio \[INR\] \&gt; 1.4).
* Localized infection at the block site.
* Morbidly obese patients.

Primary outcomes:
measure: • Rescue morphine consumption in both groups. (Total consumption of morphine rescue shots in milligram in first 2r hours)
timeFrame: twenty four hours.
Secondary outcomes:
Other outcomes:
Locations:
Study officials:
References:
citation: Cosarcan SK, Ercelen O. The analgesic contribution of external oblique intercostal block: Case reports of 3 different surgeries and 3 spectacular effects. Medicine (Baltimore). 2022 Sep 9;101(36):e30435. doi: 10.1097/MD.0000000000030435.