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NCT Number: NCT07324863

Ultrasound Guided External Oblique and Rectus Abdominis Plane Block (EXORA) on Neuroendocrine Stress Response in Adults Undergoing Umbilical Hernia Surgery

This study aims to evaluate the efficacy of ultrasound-guided external oblique and rectus abdominis plane block on the neuroendocrine stress response and postoperative analgesia in adults undergoing umbilical hernia repair.

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Key information

Conditions

Ultrasound Congenital, Hereditary, and Neonatal Diseases and Abnormalities External Oblique Hernia Hernia, Abdominal Hernia, Umbilical Hernia, Ventral Infant, Newborn, Diseases Neuroendocrine Stress Response Pathological Conditions, Anatomical Pathological Conditions, Signs and Symptoms Rectus Abdominis Plane Block Umbilical Hernia

Age range

21 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Tanta University

Tanta, 31527, Egypt

Location status: Recruiting

About this study

Umbilical hernias of the abdomen are defined as a non-inguinal, non-hiatal defect in the fascia of the abdominal wall. Surgical stress response refers to the physiologic response to surgery and the hormonal and metabolic changes that follow it.

Fascial plane blocks are gaining attention for perioperative analgesia due to their efficacy and safety profiles. The external oblique and rectus abdominis plane (EXORA) block is an emerging technique that provides a sensory block to the anterolateral abdominal wall, potentially filling gaps left by other commonly used blocks, such as the quadratus lumborum (QLB) or erector spinae plane (ESP) blocks.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Aged from 21 to 65 years.
  • Both sexes.
  • American Society of Anesthesiologists (ASA) Physical status I and Ⅱ.
  • Schedule for elective umbilical hernia surgery under general anesthesia.

Exclusion criteria

  • ASA Ⅲ or Ⅳ.
  • Patients with metabolic abnormalities, e.g., diabetes mellitus.
  • Patients receiving corticosteroids.
  • History of allergies to local anesthetics.
  • Bleeding or coagulation disorders.
  • Anatomical abnormalities.
  • Psychiatric and neurological disorders.
  • Complicated hernial defect (obstructed).
  • Patient refusal.

Treatment and study plan

General anesthesia

Other

Patients will receive general anesthesia only.

External oblique and rectus abdominis plane (EXORA) block

Other

Patients will receive general anesthesia and an external oblique and rectus abdominis plane (EXORA) block with 0.25% bupivacaine.

Primary outcomes

  1. Neuroendocrine stress response

    Time frame: 24 hours postoperatively

    Neuroendocrine stress response will be measured by blood glucose level in adults undergoing umbilical hernia repair.

Secondary outcomes

  1. Serum cortisol level

    Time frame: 24 hours postoperatively

    Serum cortisol level will be measured.

  2. Time of first rescue analgesia

    Time frame: 24 hours postoperatively

    Time of first rescue analgesia will be recorded from the end of surgery till first dose of morphine administration.

  3. Total intraoperative fentanyl consumption

    Time frame: Intraoperatively

    Rescue dose of intraoperative fentanyl given will be recorded.

  4. Total morphine consumption

    Time frame: 24 hours postoperatively

    Intravenous morphine (rescue analgesic) at a dosage of 3 mg will be administered when the Numerical Rating Scale (NRS) score will be ≥ 4. The total morphine consumption over a 24-hours period will be recorded for these individuals.

  5. Degree of pain

    Time frame: 24 hours postoperatively

    Each patient will be instructed in postoperative pain assessment using the Numerical Rating Scale (NRS), ranging from 0 to 10 (0 = "no pain," 10 = "the worst pain imaginable"). NRS will be assessed at post-anesthesia care unit (PACU),1,2,4,6,12,24 hours postoperative

Interested in participating?

Recruiting

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Sponsors and collaborators

Lead sponsor

Tanta University

Other

Registry information

Official study title

The Effect of Ultrasound Guided External Oblique and Rectus Abdominis Plane Block (EXORA) on Neuroendocrine Stress Response in Adults Undergoing Umbilical Hernia Surgery: A Prospective Randomized Controlled Trial

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Jan 8, 2026
Registry last updated
Jan 8, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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