Analgesic Efficacy of Ultrasound-guided External Oblique Intercostal Plane Block Versus Posterior Transversus Abdominis Plane Block in Patients Undergoing Open Nephrectomy
Analgesic Efficacy of Ultrasound-guided External Oblique Intercostal Plane Block Versus Posterior Transversus Abdominis Plane Block in Patients Undergoing Open Nephrectomy: A Randomized Double-blinded Comparative Study
Renal cell carcinoma (RCC) accounts for 2-3% of all cancers and is a common malignancy of the genitourinary tract. Open nephrectomy, performed through midline, subcostal, or flank incisions, remains a standard treatment but often results in significant postoperative pain, leading to respiratory muscle dysfunction, increased pulmonary complications, and prolonged hospital stays.
Acute surgical pain arises from inflammatory responses, activation of spinal pain pathways, and muscle spasms. While postoperative pain typically improves during recovery, some patients develop chronic postsurgical pain (CPSP), lasting at least two months postoperatively.
Opioids and epidural analgesia are commonly used for pain control, but their side effects and invasiveness necessitate safer, effective alternatives. Ultrasound (US)-guided peripheral nerve and field blocks have become integral to multimodal analgesia. One such technique, the **external oblique intercostal plane block (EOIPB)**, was introduced as a modification of fascial plane blocks, targeting anterior and lateral cutaneous nerves (T6-T10). EOIPB offers advantages over quadratus lumborum block (QLB) and erector spinae plane block (ESPB) by being performed in the supine position and providing superior midline analgesia compared to serratus intercostal plane block (SIPB).
Similarly, the transversus abdominis plane (TAP) block, particularly the posterior approach, delivers analgesia from T7 to T12 by anesthetizing anterior and lateral cutaneous nerve branches. While case series suggest EOIPB may be effective for post-nephrectomy pain, comparative studies between EOIPB and posterior TAP block in open nephrectomy:
Aim of the Study:
To evaluate the postoperative analgesic effects of posterior transversus abdominis plane (TAP) block and external oblique intercostal plane block (EOIPB) in patients undergoing open nephrectomy under general anesthesia.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Abeer A Mohamed
- Phone Number: 01005244590
- Email: abeer_ahmed@kasralainy.edu.eg
Study Locations
-
-
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Cairo, Egypt, 00225
- Recruiting
- Kasr Alainy Faculty of Medicine - Cairo university
-
Contact:
- Abeer Ahmed, MD
-
-
Cairo Governorate
-
Maadi, Cairo Governorate, Egypt, 11728
- Completed
- Abeer Ahmed Mohamed
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients whom diagnosed as having renal carcinoma and scheduled for open nephrectomy under general anesthesia.
- ASA class II- III.
- Age ≥ 18 and ≤ 70 years.
- Body mass index (BMI) less than 40kg/m2.
Exclusion Criteria:
- Patient refusal.
- Hepatic and renal insufficiency.
- Unstable cardiovascular or pulmonary disease.
- History of psychiatric and cognitive disorders.
- Patients with known sensitivity or contraindications to the drug used.
- Patients on regular opioid consumption.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Active Comparator: EOIPB-Group
|
US Guided external oblique intercostal plane block (EOIPB) or Posterior TAP Block:
Other Names:
|
|
Active Comparator: Posterior TAP - Group
|
US Guided external oblique intercostal plane block (EOIPB) or Posterior TAP Block:
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Postoperative morphine consumption (mg) in the first 24 hrs .
Time Frame: Time elapsed from the end of the block procedure till the end of the 24 hours postoperatively
|
Time elapsed from the end of the block procedure till the end of the 24 hours postoperatively
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- MS-389-2024
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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