Analgesic Efficacy of Erector Spinae Plane Block vs External Oblique Intercostal Plane Block in Subcostal Cancer Surgeries

National Cancer Institute, Egypt

Status: Completed

Conditions: Subcostal Cancer Surgeries; External Oblique Intercostal Plane Block; Erector Spinae Plane Block; Analgesia

Treatments: Drug: External Oblique Intercostal Plane Block; Drug: Erector Spinae Plane Block

Study type: Interventional

Funder types: Other

Identifiers

NCT06519708

AP2403-201-107

Details and patient eligibility

About

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.

Full 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.

Enrollment: 70 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

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.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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70 participants in 2 patient groups

Erector Spinae Plane Block

Active Comparator group

Description:

Patients will receive an ultrasound-guided erector spinae plane block with the injection of 30 ml bupivacaine 0.25% after induction of general anesthesia.

Treatment:

Drug: Erector Spinae Plane Block

External Oblique Intercostal Plane Block

Experimental group

Description:

Patients will receive an ultrasound-guided external oblique intercostal plan block Intraoperative with the injection of 30 ml bupivacaine 0.25% after induction of general anesthesia.

Treatment:

Drug: External Oblique Intercostal Plane Block