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NCT Number: NCT07366138

Ultrasound-Guided External Oblique Intercostal Plane Block Versus Subcostal Transversus Abdominis Plane Block For Perioperative Analgesia in Laparoscopic Sleeve Gastrectomy

This study aims to compare the analgesic efficacy, duration of analgesia, and overall opioid consumption between the external oblique intercostal plane (EOIP) block and subcostal transversus abdominis plane (TAP) block in patients undergoing laparoscopic sleeve gastrectomy.

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Key information

Conditions

Ultrasound External Oblique Intercostal Plane Block Laparoscopic Sleeve Gastrectomy Perioperative Analgesia Subcostal Transversus Abdominis Plane Block

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Benha University

Banhā, Benha, 13518, Egypt

Location status: Recruiting

Location contact

Ahmed A Ali, MBBCH

CONTACT

[email protected]

00201067850909

El sayed M Abd Elazeem, MD

SUB_INVESTIGATOR

Fatma A Abd Elfataah, MD

SUB_INVESTIGATOR

Zienab M Abd Elwahab, MD

SUB_INVESTIGATOR

About this study

Postoperative pain management is a critical aspect of enhanced recovery after surgery (ERAS) protocols, particularly in laparoscopic bariatric procedures such as sleeve gastrectomy.

Among the ultrasound-guided abdominal wall blocks, the transversus abdominis plane (TAP) block and its subcostal variant have demonstrated efficacy for upper abdominal surgeries. The subcostal TAP block provides analgesia for the T6-T9 dermatomes, covering incisions in upper abdominal procedures like laparoscopic cholecystectomy and bariatric surgery.

The external oblique intercostal plane (EOIP) block is a relatively new fascial plane block that targets the intercostal nerves lying between the external oblique and intercostal muscles.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Age from 18 to 65 years.
  • Both genders.
  • American Society of Anesthesiologists (ASA) class I or II
  • Body mass index (BMI) between 30-50 kg/m².
  • Scheduled for elective laparoscopic sleeve gastrectomy under general anesthesia.
  • Written informed consent from patients or surrogate decision makers.

Exclusion criteria

  • Patient refusal.
  • Allergy to local anesthetics.
  • Coagulation disorders or anticoagulant therapy.
  • Local infection or scar at the injection site.
  • Severe hepatic or renal dysfunction.
  • Chronic opioid use or psychiatric illness interfering with pain assessment.
  • Conversion to open surgery or intraoperative complications requiring re-exploration.

Treatment and study plan

External Oblique Intercostal Plane Block

Other

Patients will receive an ultrasound-guided bilateral external oblique intercostal plane (EOIP) block using 20 mL of 0.25% bupivacaine in each side after induction of anesthesia and prior to surgical incision.

Subcostal Transversus Abdominis Plane Block

Other

Patients will receive a bilateral subcostal transversus abdominis plane (TAP) block using 20 mL of 0.25% bupivacaine in each side, under ultrasound guidance and identical conditions.

Primary outcomes

  1. Total morphine consumption

    Time frame: 24 hours postoperatively

    Patient-controlled analgesia (PCA) using intravenous morphine (1 mg bolus, 10-minute lockout) will be available for rescue analgesia when visual analogue score ( VAS ) > 3.

Secondary outcomes

  1. Time to first rescue analgesia

    Time frame: 24 hours postoperatively

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

  2. Degree of pain

    Time frame: 24 hours postoperatively

    Each patient will be instructed about postoperative pain assessment with the visual analogue score (VAS). VAS (0 represents "no pain" while 10 represents "the worst pain imaginable").

    VAS will be recorded at 0, 2, 6, 12, and 24 hours postoperatively (at rest and cough).

  3. Heart rate

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

    Heart rate will be recorded intraoperatively and postoperatively

  4. Mean arterial blood pressure

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

    Mean arterial blood pressure will be recorded intraoperatively and postoperatively

  5. Incidence of postoperative nausea and vomiting

    Time frame: 24 hours postoperatively

    Incidence of postoperative nausea and vomiting (PONV) will be recorded.

  6. Block-related complications

    Time frame: 24 hours postoperatively

    Block-related complications such as pleural puncture, local anesthetic toxicity, and hematoma will be recorded.

  7. Degree of patient satisfaction

    Time frame: 24 hours postoperatively

    Patient satisfaction will be assessed using a 5-point Likert scale at 24 hours (1 = very dissatisfied , 2 = dissatisfied, 3 =mild, 4= moderate satisfaction, 5 = very satisfied ).

Study contacts

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

Ahmed A Ali, MBBCH

CONTACT

[email protected]

00201067850909

Sponsors and collaborators

Lead sponsor

Benha University

Other

Registry information

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Jan 26, 2026
Registry last updated
Jan 26, 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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