Bilateral Erector Spinae Plane Block Versus Bilateral Oblique Subcostal Transversus Abdominis Plane Block for Postoperative Analgesia in Colorectal Surgery

Ultrasound-Guided Bilateral Erector Spinae Plane Block Versus Bilateral Oblique Subcostal Transversus Abdominis Plane Block for Postoperative Analgesia in Colorectal Surgery: A Prospective Randomized Study.

This study aims to compare the ultrasound-guided bilateral erector spinae plane block (ESPB) and oblique subcostal transverse abdominal plane block (OSTAPB) for postoperative analgesia in colorectal surgery.

Study Overview

• Status: Recruiting
• Conditions: Colorectal Surgery; Postoperative Analgesia; Bilateral Erector Spinae Plane Block; Bilateral Oblique Subcostal Transversus Abdominis Plane Block
• Intervention / Treatment: Other: Erector Spinae Plane Block; Other: Oblique Subcostal Transversus Abdominis Plane Block

Detailed Description

Colorectal surgery remains the therapeutic cornerstone for the management of a wide variety of gastrointestinal disorders encompassing malignancies and inflammatory conditions.

Oblique subcostal transverse abdominal plane block (OSTAPB) is a regional block technique that involves injecting local anesthetics between the transverse abdominal muscle plane and the internal oblique abdominal muscle plane.

Ultrasound-guided erector spinae plane block (ESPB) is a novel technique that specifically targets the ventral rami, dorsal rami, and rami communicantes of the spinal nerves. Local anesthetic agents were observed to extend cranially and caudally over numerous dermatomal levels following injection.

• Study Type: Interventional
• Enrollment (Estimated): 50
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Mohammed M Alarousy, MSc; Phone Number: 00201149404478; Email: mohammedalarousy0@gmail.com

Study Locations

• Egypt
  • Cairo, Egypt, 12613
    • Recruiting
    • Cairo University
    • Contact: Mohammed M Alarousy, MSc; Phone Number: 00201149404478; Email: mohammedalarousy0@gmail.com
    • Sub-Investigator: Dina Z Khalaf, MD
    • Sub-Investigator: Tamer K Khair, MD
    • Sub-Investigator: Shady R Mikhail, MD
    • Sub-Investigator: Michael W Halim, MD

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Age 18 to 75 years old.
• Both sexes.
• American Society of Anesthesiologists (ASA) physical status II-III.
• Scheduled for open colorectal surgery under general anesthesia.

Exclusion Criteria:

• History of opioid abuse.
• Chronic opioid consumption.
• Body mass index (BMI) ≥ 35 kg/m2.
• Severe cardiac insufficiency, defined as New York Heart Association (NYHA) class III or IV heart failure.
• Renal failure, defined as an estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m².
• Hepatic encephalopathy.
• Having a skin infection at or near the puncture site.
• Coagulopathy, defined as platelet count < 100,000/mm³, INR > 1.5, or use of anticoagulant therapy that could not be withheld.
• Allergy to drugs used in the study.
• History of previous or recurrent laparoscopic cholecystectomy procedures.

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
Experimental: Group I; Patients will receive ultrasound-guided erector spinae plane block.	Other: Erector Spinae Plane Block; Patients will receive ultrasound-guided erector spinae plane block.
Experimental: Group II; Patients will receive ultrasound-guided oblique subcostal transversus abdominis plane block.	Other: Oblique Subcostal Transversus Abdominis Plane Block; Patients will receive ultrasound-guided oblique subcostal transversus abdominis plane block.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Degree of pain	Each patient will be instructed about postoperative pain assessment with the numeric rating scale (NRS). NRS (0 represents "no pain" while 10 represents "the worst pain imaginable"). NRS will be assessed at 0, 2, 4, 6, 12, and 24 h postoperatively.	24 hours postoperatively

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Intraoperative fentanyl consumption	Additional fentanyl bolus dosages of 1 µg/kg IV will be administered if heart rate or mean arterial blood pressure elevated more than 20% of the baseline (after exclusion of other causes than pain).	Intraoperatively
Degree of patient satisfaction	Degree of patient satisfaction will be assessed on a 5-point Likert scale patient satisfaction (1, extremely dissatisfied; 2, unsatisfied; 3, neutral; 4, satisfied; 5, extremely satisfied).	24 hours postoperatively
Incidence of adverse events	Incidence of adverse events such as bradycardia, hypotension, nausea, vomiting, respiratory depression, or any other complication will be recorded.	24 hours postoperatively
Time to the first rescue analgesia	Time to the first request for the rescue analgesia will be recorded from end of surgery to first dose of morphine administrated.	24 hours postoperatively
Total morphine consumption	Rescue analgesia of morphine will be given as 3 mg bolus (maximum dose of 0.5 mg/kg/24hours) if the numeric rating scale (NRS) > 3 to be repeated after 30 min if pain persists until the NRS < 4.	24 hours postoperatively
Mean arterial pressure	Mean arterial pressure will be recorded at: T0: Baseline reading preoperatively (in the preoperative holding area).; T1: Immediately before intubation.; T2: 15 minutes after intubation.; T3: 30 minutes after intubation.; T4: 45 minutes after intubation.; T5: 60 minutes after intubation.; T6: At the end of surgery.	Till end of surgery (Up to 2 hours)
Heart rate	Heart rate will be recorded at: T0: Baseline reading preoperatively (in the preoperative holding area).; T1: Immediately before intubation.; T2: 15 minutes after intubation.; T3: 30 minutes after intubation.; T4: 45 minutes after intubation.; T5: 60 minutes after intubation.; T6: At the end of surgery.	Till end of surgery (Up to 2 hours)
Quality of Recovery	Quality of Recovery (QOR- 15) scale will be recorded at 24 hours after surgery. Each item on the QoR-15 scale is scored from 0 (unfavourable) to 10 (favourable), resulting in an aggregate score from 0 (no recovery) to 150 (total recovery).	24 hours postoperatively

Collaborators and Investigators

• Sponsor: Cairo University

Study record dates

Study Major Dates

• Study Start (Actual): May 21, 2026
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): December 1, 2026

Study Registration Dates

• First Submitted: May 16, 2026
• First Submitted That Met QC Criteria: May 16, 2026
• First Posted (Actual): May 22, 2026

Study Record Updates

• Last Update Posted (Actual): May 22, 2026
• Last Update Submitted That Met QC Criteria: May 21, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: MD-316-2026

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
• IPD Sharing Time Frame: After the end of study for one year.
• IPD Sharing Access Criteria: The data will be available upon a reasonable request from the corresponding author.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

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