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NCT Number: NCT07273136

Combined Subcostal and Lateral Transversus Abdominis Plane Block for Postoperative Analgesia Versus Thoracic Epidural Analgesia in Patients Undergoing Major Abdominal Cancer Surgery

This study aims to evaluate the safety and efficacy of combined subcostal and lateral transversus abdominis plane (TAP) for postoperative analgesia versus thoracic epidural anesthesia (TEA) in patients undergoing major abdominal cancer surgery.

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Key information

Conditions

Subcostal Lateral Major Abdominal Cancer Surgery Postoperative Analgesia Thoracic Epidural Analgesia Transversus Abdominis Plane Block

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

About this study

Postoperative pain is treated using a variety of techniques. It is possible to deliver opioids intravenously, neuraxially, or both.

Thoracic epidural anesthesia (TEA) has long been considered the benchmark for analgesia in major abdominal operations due to its consistent efficacy in pain control and additional benefits such as reduced ileus and improved pulmonary function.

Transversus abdominis plane (TAP) blocks can be a critical component of postoperative pain management, and they play a crucial role in Enhanced Recovery After Surgery (ERAS) protocols, as they significantly affect recovery and patient well-being.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Age ≥ 18 years.
  • Both sexes.
  • American Society of Anesthesiologists (ASA) physical status I-III.
  • Scheduled for major abdominal surgeries including: (e.g., gastrectomy, colectomy, hepatectomy, cystectomy, total abdominal hysterectomy, Nephrectomy, pancreatectomy).

Exclusion criteria

  • Intraoperative hemodynamic instability.
  • History or evidence of coagulopathy.
  • Infection or abdominal wall masses at injection site.
  • Morbid obesity.
  • Other Medical conditions including mental illness or substance abuse.
  • Known allergy to local anesthetics.
  • Chronic opioid use or chronic pain conditions.
  • Pregnancy.

Treatment and study plan

Subcostal and lateral transversus abdominis plane block

Other

Patients will receive an ultrasound-guided combined subcostal and lateral transversus abdominis plane block.

Thoracic epidural anesthesia

Other

Patients will receive an ultrasound-guided thoracic epidural anesthesia.

Primary outcomes

  1. Total morphine consumption

    Time frame: 24 hours postoperatively

    Rescue analgesia of morphine will be given as 3 mg bolus if the Visual Analogue Scale (VAS) > 3 to be repeated after 30 min if pain persists until the VAS < 4.

Secondary outcomes

  1. Time to the 1st rescue analgesia

    Time frame: 24 hours postoperatively

    Time to the first request for the rescue analgesia (time from the end of surgery to first dose of morphine administrated).

  2. Mean arterial pressure

    Time frame: Till the end of surgery (Up to 2 hours)

    Mean arterial pressure will be recorded before skin incision, one minute after skin incision and then recorded regularly every 10 minutes.

  3. Heart rate

    Time frame: Till the end of surgery (Up to 2 hours)

    Heart rate will be recorded before skin incision, one minute after skin incision and then recorded regularly every 10 minutes.

  4. Degree of pain

    Time frame: 24 hours postoperatively

    Each patient will be instructed about postoperative pain assessment with the Visual Analogue Scale (VAS). VAS (0 represents "no pain" while 10 represents "the worst pain imaginable"). VAS will be assessed at 0, 4, 6, 8, 12, and 24 h postoperatively.

  5. Incidence of adverse events

    Time frame: 24 hours postoperatively

    Incidence of adverse events such as bradycardia, hypotension, nausea, vomiting, respiratory depression, or any other complication.

Study contacts

Contact information is provided by the study sponsor or research team.

Bahaa G Saad, MD

CONTACT

[email protected]

00201555590977

Sponsors and collaborators

Lead sponsor

Assiut University

Other

Registry information

Official study title

Safety and Efficacy of Combined Subcostal and Lateral Transversus Abdominis Plane Block for Postoperative Analgesia Versus Thoracic Epidural Analgesia in Patients Undergoing Major Abdominal Cancer Surgery

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Dec 9, 2025
Registry last updated
Dec 11, 2025

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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