External Oblique Intercostal Plane Block Versus Erector Spinae Plane Block in Paediatric Upper Abdominal Surgeries

Ultrasound Guided External Oblique Intercostal Plane Block Versus Erector Spinae Plane Block in Paediatric Upper Abdominal Surgeries

This study aims to compare between ultrasound guided external oblique intercostal plane block and ultrasound guided erector spinae plane block in paediatric upper abdominal surgeries.

Study Overview

• Status: Recruiting
• Conditions: Erector Spinae Plane Block; Pediatric; External Oblique Intercostal Plane Block; Upper Abdominal Surgeries
• Intervention / Treatment: Other: External oblique intercostal plane block; Other: Erector spinae plane block

Detailed Description

Paediatric nerve blocks are increasingly recognized as new standard for managing pain in children. The advantages of regional anesthesia in this population include enhanced operating conditions, expedited recovery of bowel function, and reduced postoperative pain.

The caudal epidural block remains the most used method; however, the external oblique intercostal block, a novel technique involves administering local anesthesia deep to the external oblique muscle at the sixth intercostal space, thereby blocking thoracoabdominal nerves from T6 to T10. This technique offers several advantages, including straightforward anatomy, a single muscle strip that is easily identifiable even in obese patients, a bony backstop, and an easily expandable fascial plane that can accommodate a catheter.

The erector spinae plane block involves injecting local anesthetic into the fascial plane beneath the erector spinae muscle at the tip of the vertebral transverse process. This allows the local anesthetic to spread in the craniocaudal fascial plane.

• Study Type: Interventional
• Enrollment (Estimated): 40
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Belal M Hassan, MBBCH; Phone Number: 00201091397908; Email: Belal.bakr1420@alexmed.edu.eg

Study Locations

• Egypt
  • Alexandria, Egypt, 21526
    • Recruiting
    • Alexandria University
    • Contact: Belal M Hassan, MBBCH; Phone Number: 00201091397908; Email: Belal.bakr1420@alexmed.edu.eg
    • Sub-Investigator: Wafaa M Shafshak, MD
    • Sub-Investigator: Ola M Zanaty, MD
    • Sub-Investigator: Mohamed W Nassar, MD

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Children aged between 6 and 12 years of both sex.
• Patients with the American Society of Anesthesiologists (ASA) physical status I/II.
• Patients undergoing upper abdominal surgeries involving upper abdominal incisions.

Exclusion Criteria:

• Guardian refusal.
• Allergy to local anesthetics.
• Surgical procedures exceeding 3 hours.
• Infection at the area planned for the block injection.
• Prolonged opioid medication.
• Patients preoperatively medicated by Beta blockers

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 external oblique intercostal plane block.	Other: External oblique intercostal plane block; Patients will receive ultrasound-guided external oblique intercostal plane block.
Experimental: Group II; Patients will receive ultrasound-guided erector spinae plane block.	Other: Erector spinae plane block; Patients will receive ultrasound-guided erector spinae plane block.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Degree of pain	Postoperative pain will be assessed using Faces pain score revised. The Faces Pain Scale revised (FPS-R) is a validated self-report instrument designed to measure pain intensity in pediatric populations. The scale comprises a series of facial expressions, ranging from a smiling face at 0, indicating "no pain," to a crying face at 10, indicating "very much pain". Children are instructed to select the face that most accurately reflects their current pain level. The faces are scored (0, 2, 4, 6, 8, 10), providing a quantifiable measure of pain intensity.	12 hours after surgery

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Heart rate	Heart rate will be recorded preoperative basal readings, after induction of anesthesia, during skin incision, and every 15 minutes intraoperative.	Every 15 minutes intraoperative
Mean arterial blood pressure	Mean arterial blood pressure will be recorded preoperative basal readings, after induction of anesthesia, during skin incision, and every 15 minutes intraoperative.	Every 15 minutes intraoperative
Peripheral oxygen saturation	Peripheral oxygen saturation will be recorded preoperative basal readings, after induction of anesthesia, during skin incision, and every 15 minutes intraoperative.	Every 15 minutes intraoperative
Duration of analgesia	Duration of analgesia will be recorded from block completion till first postoperative rescue analgesia requirement.	12 hours after surgery
Total rescue analgesia requirement	In Faces Pain Scale score-revised, cut of points for analgesic requirement is ≧ 4, rescue analgesia will be administered in the form of nalbuphine 0.1 mg/kg, with a maximum dose of 0.2 mg/kg.	12 hours after surgery
Incidence of complications	Incidence of complications including hematomas block failure, intravascular injection, pneumothorax or injection into the peritoneal cavity, with associated risks of damage to bowel and other abdominal viscera at the block site will be recorded.	12 hours after surgery

Collaborators and Investigators

• Sponsor: Alexandria University

Study record dates

Study Major Dates

• Study Start (Actual): May 1, 2025
• Primary Completion (Estimated): October 1, 2026
• Study Completion (Estimated): October 1, 2026

Study Registration Dates

• First Submitted: May 24, 2026
• First Submitted That Met QC Criteria: May 24, 2026
• First Posted (Actual): June 1, 2026

Study Record Updates

• Last Update Posted (Actual): June 1, 2026
• Last Update Submitted That Met QC Criteria: May 24, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: 00012098 (0109306)

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