Efficacy of Ultrasound-guided External Oblique Intercostal Plane Block Versus Port-site Local Anesthetic Infiltration for Postoperative Analgesia and Pulmonary Function After Laparoscopic Sleeve Gastrectomy

September 7, 2026 updated by: Hazem Samir Mohamed Ahmed, Assiut University
Obesity poses severe global health risks and induces complex cardiorespiratory alterations, making perioperative care critical. For patients with morbid obesity, Laparoscopic Sleeve Gastrectomy (LSG) is the most effective long-term treatment. However, despite being minimally invasive, LSG causes significant early postoperative pain from trocar insertion, pneumo-peritoneum, and visceral trauma. Uncontrolled pain can lead to impaired respiratory function, delayed recovery, and increased opioid-related side effects. Enhanced Recovery After Surgery (ERAS) protocols emphasize opioid-sparing multimodal analgesia. While local port-site infiltration is inexpensive and simple, its effects are localized and short-lived, often requiring supplemental opioids. In contrast, the ultrasound-guided External Oblique Intercostal (EOI) block targets the fascial plane between the external oblique and intercostal muscles (T6-T10). It provides superficial, easily identifiable landmarks in obese patients and delivers widespread sensory blockade across the upper anterior abdominal wall. To evaluate superior pain management strategies, a prospective, randomized, controlled study compares the analgesic efficacy of ultrasound-guided bilateral EOI block versus conventional port-site local anesthetic infiltration in patients undergoing elective LSG. Key Study Metrics (First 24 Postoperative Hours) Primary Outcomes: Total postoperative opioid consumption and pain scores. Secondary Outcomes: Time to first rescue analgesia, incidence of postoperative nausea and vomiting (PONV), overall patient satisfaction, and recovery metrics. Ultimately, demonstrating the superior efficacy of the EOI block over port-site infiltration may refine perioperative analgesic protocols, reduce opioid dependence, and improve recovery outcomes in bariatric surgery.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

54

Phase

  • Not Applicable

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • • Age 18-65 years

    • BMI between 35 kg/m2 and 40 kg/m²
    • ASA (I-II-III)
    • Elective laparoscopic sleeve gastrectomy
    • Ability to provide informed consent

Exclusion Criteria:

  • • Patient refusal

    • Allergy to local anesthetics
    • Coagulopathy
    • Infection at injection site
    • Chronic opioid use
    • Hepatic failure
    • Renal failure
    • Conversion to open surgery
    • OSAS-home CPAP
    • Cardiac patients
    • Super morbid >50 kg / m²

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Group I
External Oblique Intercostal Block, EOI
Procedure: External Oblique Intercostal Block
ultrasound-guided external oblique intercostal block with 30 ml 0.25% bupivacaine bilaterally.
Active Comparator: Group II
Port-Site Local Anesthetic Infiltration
Procedure: Port-Site Local Anesthetic Infiltration
patients undergoing laparoscopic sleeve gastrectomy receiving port-site infiltration with 5 ml 0.25% bupivacaine at each port site.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Total opioid consumption
Time Frame: 24 hours
Total opioid consumption (IV NALUFIN) during the first 24 postoperative hours
24 hours

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Assiut University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

October 1, 2026

Primary Completion (Estimated)

October 1, 2027

Study Completion (Estimated)

December 1, 2027

Study Registration Dates

First Submitted

September 7, 2026

First Submitted That Met QC Criteria

September 7, 2026

First Posted (Actual)

September 11, 2026

Study Record Updates

Last Update Posted (Actual)

September 11, 2026

Last Update Submitted That Met QC Criteria

September 7, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • EOIPB VS Local Analgesia LSG

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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