Combined Subcostal and Lateral Transversus Abdominis Plane Block for Postoperative Analgesia Versus Thoracic Epidural Analgesia in Patients Undergoing Major Abdominal Cancer Surgery

Assiut University

Status: Enrolling

Conditions: Thoracic Epidural Analgesia; Postoperative Analgesia; Subcostal; Transversus Abdominis Plane Block; Lateral; Major Abdominal Cancer Surgery

Treatments: Other: Thoracic epidural anesthesia; Other: Subcostal and lateral transversus abdominis plane block

Study type: Interventional

Funder types: Other

Identifiers

NCT07273136

620

Details and patient eligibility

About

This study aims to evaluate the safety and efficacy of combined subcostal and lateral transversus abdominis plane (TAP) for postoperative analgesia versus thoracic epidural anesthesia (TEA) in patients undergoing major abdominal cancer surgery.

Full description

Postoperative pain is treated using a variety of techniques. It is possible to deliver opioids intravenously, neuraxially, or both.

Thoracic epidural anesthesia (TEA) has long been considered the benchmark for analgesia in major abdominal operations due to its consistent efficacy in pain control and additional benefits such as reduced ileus and improved pulmonary function.

Transversus abdominis plane (TAP) blocks can be a critical component of postoperative pain management, and they play a crucial role in Enhanced Recovery After Surgery (ERAS) protocols, as they significantly affect recovery and patient well-being.

Enrollment: 50 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age ≥ 18 years.
• Both sexes.
• American Society of Anesthesiologists (ASA) physical status I-III.
• Scheduled for major abdominal surgeries including: (e.g., gastrectomy, colectomy, hepatectomy, cystectomy, total abdominal hysterectomy, Nephrectomy, pancreatectomy).

Exclusion criteria

• Intraoperative hemodynamic instability.
• History or evidence of coagulopathy.
• Infection or abdominal wall masses at injection site.
• Morbid obesity.
• Other Medical conditions including mental illness or substance abuse.
• Known allergy to local anesthetics.
• Chronic opioid use or chronic pain conditions.
• Pregnancy.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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50 participants in 2 patient groups

Subcostal and lateral transversus abdominis plane block group

Experimental group

Description:

Patients will receive an ultrasound-guided combined subcostal and lateral transversus abdominis plane block.

Treatment:

Other: Subcostal and lateral transversus abdominis plane block

Thoracic epidural anesthesia group

Active Comparator group

Description:

Patients will receive an ultrasound-guided thoracic epidural anesthesia.

Treatment:

Other: Thoracic epidural anesthesia