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NCT Number: NCT06452238

External Oblique Intercostal Plane Block Versus Transversus Abdominis Plane Block for Postoperative Analgesia in Adult Patients Undergoing Open Nephrectomy

The aim of this study is to compare external oblique intercostal plane (EOIP) block and ultrasound guided transversus abdominis plane (TAP) Block for postoperative analgesia in adult patients undergoing open nephrectomy.

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Key information

Conditions

External Oblique Intercostal Plane Block Nephrectomy Postoperative Analgesia Transversus Abdominis Plane Block

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Tanta University

Tanta, El-Gharbia, 31527, Egypt

About this study

Patients undergoing nephrectomy have a high incidence of postoperative pain despite the use of modern laparoscopic surgical techniques. In the postoperative period, these patients are often treated with patient-controlled opioids, epidural analgesia, or both.

Ultrasound-guided transversus abdominis plane (TAP) block is a relatively new technique to infiltrate regional anesthesia in which local routine anesthetics are injected between the internal oblique and transverse abdominal muscles. Studies have confirmed that ultrasound-guided (USG) transversus abdominis plane (TAP) block is an effective method of analgesia for upper abdominal surgeries, lower abdominal surgeries, and kidney transplantation, with minimal side effects.

External oblique intercostal plane block (EOIPB) has been reported by Elsharkawy et al. in 2021 as a significant modification of fascial plane blocks in that it may engage the upper lateral abdominal walls consistently. In comparison to quadratus lumborum block (QLB) and erector spinae plane block (ESPB) , The advantage of EOIPB is that it may be performed with the patient supine. Furthermore, in comparison to serratus intercostal plane block (SIPB), it generates more extensive analgesic effects throughout the whole midline of the abdomen .

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 Anesthesiology (ASA) physical status I-II.
  • Scheduled for open nephrectomy.

Exclusion criteria

  • Bleeding disorders.
  • Skin lesions or infection at the site of proposed needle insertion.
  • Allergy to local anesthetics.
  • Neurological disorders.
  • Drug abuse.
  • BMI > 30 kg/m2.
  • Pregnancy.
  • Diabetic neuropathy.
  • Severe cardiovascular problems.

Treatment and study plan

External Oblique Intercostal Plane Block

Other

Patients will receive external oblique intercostal plane block .

Transversus abdominis plane block

Other

Patients will receive ultrasound-guided transversus abdominis plane block.

Primary outcomes

  1. Total pethidine consumption in the 1st 24hr

    Time frame: 24 hours postoperatively

    A standardized analgesic regimen will be prescribed in the postoperative period. All patients will receive paracetamol 1 gm every 6 h as routine analgesia. Rescue analgesia of pethidine will be given as 2 mg bolus if the Numerical Rating Scale (NRS) > 3 to be repeated after 30 min if pain persists until the Numerical Rating Scale (NRS) < 4. NRS will be assessed at 0, 4, 8, 12, 18 and 24h postoperatively.

Secondary outcomes

  1. Intraoperative fentanyl consumption

    Time frame: Intraoperatively

    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).

  2. Time to the 1st rescue analgesia.

    Time frame: 24 hours postoperatively

    A standardized analgesic regimen will be prescribed in the post-operative period. All patients will receive paracetamol 1 gm every 6 h as routine analgesia. Rescue analgesia of pethidine will be given as 2 mg bolus if the Numerical Rating Scale (NRS) > 3 to be repeated after 30 min if pain persists until the Numerical Rating Scale (NRS) < 4. NRS will be assessed at 0, 4, 8, 12, 18 and 24h postoperatively.

    It will be measured from the end of surgery to first dose of pethidine administrated.

  3. Degree of pain

    Time frame: 24 hours postoperatively

    Each patient will be instructed about postoperative pain assessment with the numeric rating scale (NRS) score. NRS (0 represents "no pain" while 10 represents "the worst pain imaginable"). NRS will be assessed at 0, 4, 8, 12, 18 and 24h postoperatively.

  4. Mean arterial pressure

    Time frame: Every 15 minutes till the end of surgery

    It will be recorded preoperative, before performing of block, and every 15 min till the end of surgery.

  5. Heart rate

    Time frame: Every 15 minutes till the end of surgery

    It will be recorded preoperative, before performing of block, and every 15 min till the end of surgery.

Sponsors and collaborators

Lead sponsor

Tanta University

Other

Registry information

Official study title

External Oblique Intercostal Plane Block Versus Ultrasound Guided Transversus Abdominis Plane Block for Postoperative Analgesia in Adult Patients Undergoing Open Nephrectomy

Important dates

Study start
2024
Primary completion
2025
Study completion
2025
First posted
Jun 11, 2024
Registry last updated
Nov 25, 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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