RLB vs ERSP for Postoperative Analgesia in Lap Cholecystectomy

Retrolaminar Block Versus Erector Spinae Plane Block for Postoperative Analgesia in Laparoscopic Cholecystectomy: A Comparative Randomized Prospective Study

This prospective, randomized, double-blind clinical trial evaluates the comparative effectiveness of ultrasound-guided retrolaminar block (RLB) and erector spinae plane block (ESPB) for postoperative analgesia in patients undergoing laparoscopic cholecystectomy. A total of 100 ASA I-II patients, aged 20-60 years, will be randomly allocated into two equal groups to receive either RLB or ESPB bilaterally following induction of standardized general anesthesia. The primary outcome is the time to first request for rescue analgesia, while secondary outcomes include total morphine consumption within the first 24 hours, postoperative pain scores assessed using the Numeric Rating Scale (NRS), patient satisfaction, and the incidence of adverse events. Pain assessment will be performed at predefined intervals over the first 24 hours postoperatively. The study aims to determine which technique provides superior analgesia with reduced opioid requirements and improved patient outcomes.

Study Overview

• Status: Not yet recruiting
• Conditions: Laparoscopic Cholecystectomy Surgery Postoperative Analgesia
• Intervention / Treatment: Biological: Retrolaminar Block (RLB); Procedure: Erector spinae plane block (ESPB)

• Study Type: Interventional
• Enrollment (Estimated): 100
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Esraa abdallah Mohamed, resident; Phone Number: 01066981675; Email: esraa97egy@gmail.com

Study Locations

• Egypt
  • Sohag, Egypt
    • Sohag Faculty of Medicine
    • Contact: Esraa abdallah Mohamed, resident; Phone Number: 01066981675; Email: esraa97egy@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• • Age from 20 to 60 years.

  • Both sexes.
  • American Society of Anesthesiology (ASA) grade I and II physical status.
  • Patients will undergo cholecystectomy under general anesthesia.

Exclusion Criteria:

• • Sensitivities or contraindications to the study medications.

  • Infection at the site of injection.
  • Emergency surgery.
  • Body mass index (BMI) > 35.
  • Organic comorbidities.
  • Histories of psychological conditions and/or chronic pain syndromes.
  • Contraindications to regional anesthesia.
  • Severe respiratory, cardiac, hepatic and renal disorders.
  • Pregnancy.
  • Coagulopathy.
  • Opioid addiction.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: ESPB group	Procedure: Erector spinae plane block (ESPB); The blocks will be conducted at the level of the T7 spinous process (SP) with the patient in the lateral position and the arm abducted. Using US ( curved probe ) , the T7 transverse process (TP) is identified by counting from the 12th rib. The US probe is positioned 2 - 3 cm laterally to the SP of T7 and situated over the TP of T7/T8 in the parasagittal longitudinal plane, with the erector spinae muscle (ESM) visualized over the TP. The needle is then inserted and advanced in plane from cephalad to caudad until the needle tip contacts the TP of T7. Following hydro dissection with 2 mL of isotonic saline, which elevates the ESM, 20 mL of LA mixture is administered after several negative aspirations.
Active Comparator: RLB group	Biological: Retrolaminar Block (RLB); Patients will be positioned laterally, and a curved ultrasound probe will be aligned longitudinally at the T7 vertebra. The vertebral lamina and spinous process will be identified. A needle will be inserted 1 - 1.5 cm lateral to the spinous process, advanced toward the lamina, and 20 mL of LA mixture will be injected into the fascial plane between the lamina and transversus spinae muscles bilaterally.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Time to the 1st rescue analgesia	in the 1st 24hr.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Total morphine consumption		in the 1st 24hr.
Pain score.	postoperative pain assessment with the Numeric Rating Scale (NRS). Numeric rating scale .. zero represents no pain while 10 represents the worst pain imaginable	Pain will be assessed at, 2, 4, 6, 8, 12, 18 and 24 hour postoperatively.
Degree of patient satisfaction	• Degree of patient satisfaction will be assessed on a 5-point Likert scale patient satisfaction (1 represents extremely dissatisfied 2 represesnts unsatisfied; 3 represents neutral 4 represents satisfied 5 represents extremely satisfied)	in the first 24 hours after surgery

Collaborators and Investigators

• Sponsor: Sohag University

Study record dates

Study Major Dates

• Study Start (Estimated): April 1, 2026
• Primary Completion (Estimated): September 1, 2027
• Study Completion (Estimated): September 1, 2027

Study Registration Dates

• First Submitted: May 1, 2026
• First Submitted That Met QC Criteria: May 18, 2026
• First Posted (Actual): May 20, 2026

Study Record Updates

• Last Update Posted (Actual): May 20, 2026
• Last Update Submitted That Met QC Criteria: May 18, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: soh-Med-26-3-9MS

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No