Efficacy Of Ultrasound Guided External Oblique Intercostal Plane Block for Subcostal Nephrectomy

NCT ID: NCT06056479

Last Updated: 2025-09-05

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 25 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-09-25
• Study Completion Date: 2024-02-25

Brief Summary

The patients will be randomly allocated into two equal groups using a computer program.

Group A: will receive external oblique intercostal block after induction. Group B: will receive postoperative morphine per patient request.

Detailed Description

General anaesthesia induction will be achieved using fentanyl 1µg/kg (IV), propofol 2mg/kg (IV), and0.5mg/kg of IV Atracurium. General anaesthesia will be maintained with mechanical ventilation with isoflurane with O2 \ Air mixture.

During anaesthesia maintenance Intraoperatively, if BP or heart rate (HR) increase more than 20% from baseline, intravenous morphine will be given to stabilize the patients' haemodynamics.

All patients will receive 1g intravenous paracetamol and 4mg ondansetron 8mg dexamethasone.

Conditions

Postoperative Pain

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: OTHER
• Blinding Strategy: NONE

Study Groups

external oblique intercostal block after induction

After induction of general anesthesia, external oblique intercostal blocks will be performed with patients positioned in the supine position with their ipsilateral arm abducted.

Initially the probe is placed in a cephalad to caudad paramedian direction at the anterior axillary line, and the external oblique muscle identified at the level ribs 6 and 7 in line with the xiphoid process. To confirm correct identification of the external oblique muscle, With 17gauge echogenic ultrasound needle will be advanced in plane from a superomedial-to-inferolateral direction, through the external oblique muscle.30 ml of bupivacaine 0.25% will be administered incrementally.

Group Type: ACTIVE_COMPARATOR

external oblique intercostal block

Intervention Type: PROCEDURE

20 ml of bupivacaine 0.25% will be administered by US into external oblique intercostal plane at the level of sixth rib space .

postoperative morphine per patient request

In this group no block will be done only morphine will be given intraoperatively- according to hemodynamic change and postoperative by morphine per patient request

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

external oblique intercostal block

20 ml of bupivacaine 0.25% will be administered by US into external oblique intercostal plane at the level of sixth rib space .

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• Eligible patients will be older than 18 years old with American society of anestheologist ASA physical status I, II and III scheduled for Trans-Abdominal ( Anterior Subcostal) Nephrectomy

Exclusion Criteria

• Patients who are:
• Unable to cooperate.
• Patients who have allergy to any of the study drugs.
• Patients who are on opioids.
• Known abuse of alcohol or medication.
• Local infection at the site of injection or systemic infection.
• Pregnancy
• Patients with coagulation disorders or on anticoagulation therapy

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Menoufia University

OTHER

Sponsor Role: lead

Responsible Party

Amal Gouda Elsayed Safan

lecturer of anaethesia

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

AMAL G SAFAN, MD

Role: PRINCIPAL_INVESTIGATOR

Menoufia University

Locations

Menoufia university

Cairo, Shibin Elkom, Egypt

Countries

Egypt

Other Identifiers

9/2023ANET1-1

Identifier Type: -

Identifier Source: org_study_id