Ultrasound Guided Erector Spinae Plane Block vs External Oblique Intercostal Plane Block for Nephrectomy (EOINBvsESB)

Menoufia University

Status: Completed

Conditions: Post Operative Pain

Treatments: Procedure: external oblique intercostal block; Procedure: Erector Spine block

Study type: Interventional

Funder types: Other

Identifiers

NCT06048744

9/2023ANET1-2

Details and patient eligibility

About

The patients will be randomly allocated into two equal groups using a computer program.

Group A: will receive U S guided external oblique intercostal block after induction.

Group B:

Patients will receive US guided erector spine block after induction.

Full description

Patients will be premedicated with IV midazolam (0.05 mg/kg). Under standard monitoring including Electrocardiography, Non-Invasive Blood Pressure, and Pulse Oximetry. General Anesthesia will be induced with Fentanyl (1-2 μg/kg), Propofol (2-3 mg/kg), and Atracurium (0.5-0.8 mg/kg). Pressure controlled Volume guarantee Ventilation mode will be used to maintain O2 Saturation Above 98%. Anesthesia will be maintained with Isoflurane 1.2 Minimum Alveolar Concentration inhalation

Enrollment: 25 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Eligible patients will be older than 21 years old with American society of anesthesiology ASA physical status I& II&III scheduled for elective (Subcostal) Nephrectomy

Exclusion criteria

• Patients who are:
• Uncooperative.
• Having allergy to any of the study drugs.
• Known abuse of alcohol or medication.
• Having Local infection at the site of injection or systemic infection.
• Pregnancy.
• With coagulation disorders or on anticoagulation therapy.

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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25 participants in 2 patient groups

external oblique intercostal block

Active Comparator group

Description:

After induction of general anesthesia, external oblique intercostal blocks will be performed with patients positioned in the supine position with their ipsilateral arm abducted. A 14-15 MHz linear ultrasound transducer (Sono-Site) was placed in the sagittal plane between the midclavicular and anterior axillary lines at the level of sixth rib. 30 ml of bupivacaine 0.25% will be administered incrementally. The drug will be injected after a negative aspiration into the plane deep to the external oblique muscle and superficial to the sixth and seventh ribs and their associated intercostal muscles.

Treatment:

Procedure: external oblique intercostal block

Erector Spine Block

Active Comparator group

Description:

After induction of general anesthesia, patients will be positioned in the lateral position . A linear ultrasound transducer will be placed on the midline to identify the T8 spinous process. From this position, the ultrasound transducer was moved 2-3 cm laterally to visualize the hyperechoic line of the T8 transverse process with its associated acoustic shadow inferiorly, and the overlying erector spinae muscle superiorly. 30 ml 0.25% bupivacaine will be injected.

Treatment:

Procedure: Erector Spine block