External Oblique Intercostal Plane Block Versus Subcostal Transversus Abdominis Plane Block in Supra-umbilical Surgical Incisions

Benha University

Status: Completed

Conditions: Pain, Postoperative

Treatments: Procedure: external oblique intercostal plain block (EOIP); Other: control group; Procedure: subcostal transversus abdominis plane block (SCTAP)

Study type: Interventional

Funder types: Other

Identifiers

NCT05432557

RC 1-5-2022

Details and patient eligibility

About

Various newer techniques have been proposed to enhance analgesia in upper abdominal region. The subcostal transverse abdominis plane (SCTAP) block is the deposition of local anesthetic in the transverse abdominis plane inferior and parallel to the costal margin. There is a growing consensus that the SCTAP block provides better analgesia for upper abdominal incisions than the traditional transverse abdominis plane block.

The External oblique intercostal plane (EOIP) block is a novel technique reported by Hamilton et al. performed EOPB by administering LA superior or deep of the external oblique muscle from the sixth intercostal space leading to the blockage of thoracoabdominal nerves at T6-T10. It has several attractive aspects such as easy sono-anatomy ribs one strip of muscle so easy to demonstrate even in obese patients, there is a bony backstop, easy expandable fascial plane that can accommodate a catheter and it is shallow block with no big vessels nearby.

Enrollment: 60 patients

Sex: All

Ages: 20 to 60 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

1. American Society of Anesthesiologists (ASA) physical status grade I -II,
2. Scheduled to undergo elective supra-umbilical surgeries under GA (epigastric herniotomy- gastrectomy- open cholecystectomy- nephrectomy).

Exclusion criteria

1. Allergy to local anesthetics,
2. Infection at the site of injection,
3. Coagulopathy,
4. Chronic pain syndromes,
5. Prolonged opioid medication,
6. Patients who received any analgesic 24 h before surgery.
7. Chronic liver disease, chronic renal disease, and cognitive impairment.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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60 participants in 3 patient groups, including a placebo group

Group E

Experimental group

Description:

patients will receive ultrasound guided external oblique intercostal plain block.

Treatment:

Procedure: external oblique intercostal plain block (EOIP)

Group T

Experimental group

Description:

patients will receive ultrasound guided subcostal transversus abdominis plane block.

Treatment:

Procedure: subcostal transversus abdominis plane block (SCTAP)

Group C

Placebo Comparator group

Description:

patients won't receive LA injection

Treatment:

Other: control group