Analgesic Efficacy of Ultrasound-guided External Oblique Intercostal Plane Block Versus Posterior Transversus Abdominis Plane Block in Patients Undergoing Open Nephrectomy

NCT ID: NCT06892743

Last Updated: 2025-03-25

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 56 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-04-30
• Study Completion Date: 2025-12-31

Brief Summary

Renal cell carcinoma (RCC) accounts for 2-3% of all cancers and is a common malignancy of the genitourinary tract. Open nephrectomy, performed through midline, subcostal, or flank incisions, remains a standard treatment but often results in significant postoperative pain, leading to respiratory muscle dysfunction, increased pulmonary complications, and prolonged hospital stays.

Acute surgical pain arises from inflammatory responses, activation of spinal pain pathways, and muscle spasms. While postoperative pain typically improves during recovery, some patients develop chronic postsurgical pain (CPSP), lasting at least two months postoperatively.

Opioids and epidural analgesia are commonly used for pain control, but their side effects and invasiveness necessitate safer, effective alternatives. Ultrasound (US)-guided peripheral nerve and field blocks have become integral to multimodal analgesia. One such technique, the **external oblique intercostal plane block (EOIPB)**, was introduced as a modification of fascial plane blocks, targeting anterior and lateral cutaneous nerves (T6-T10). EOIPB offers advantages over quadratus lumborum block (QLB) and erector spinae plane block (ESPB) by being performed in the supine position and providing superior midline analgesia compared to serratus intercostal plane block (SIPB).

Similarly, the transversus abdominis plane (TAP) block, particularly the posterior approach, delivers analgesia from T7 to T12 by anesthetizing anterior and lateral cutaneous nerve branches. While case series suggest EOIPB may be effective for post-nephrectomy pain, comparative studies between EOIPB and posterior TAP block in open nephrectomy:

Aim of the Study:

To evaluate the postoperative analgesic effects of posterior transversus abdominis plane (TAP) block and external oblique intercostal plane block (EOIPB) in patients undergoing open nephrectomy under general anesthesia.

Conditions

Postoperative Pain

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: TRIPLE

Study Groups

EOIPB-Group

Group Type: ACTIVE_COMPARATOR

US-guided external oblique intercostal plane block (EOIPB)

Intervention Type: PROCEDURE

US Guided external oblique intercostal plane block (EOIPB) or Posterior TAP Block:

Posterior TAP - Group

Group Type: ACTIVE_COMPARATOR

US-guided external oblique intercostal plane block (EOIPB)

Intervention Type: PROCEDURE

US Guided external oblique intercostal plane block (EOIPB) or Posterior TAP Block:

Interventions

US-guided external oblique intercostal plane block (EOIPB)

US Guided external oblique intercostal plane block (EOIPB) or Posterior TAP Block:

Intervention Type: PROCEDURE

Other Intervention Names

US Guided Posterior TAP Block:

Eligibility Criteria

Inclusion Criteria

• Patients whom diagnosed as having renal carcinoma and scheduled for open nephrectomy under general anesthesia.
• ASA class II- III.
• Age ≥ 18 and ≤ 65 years.
• Body mass index (BMI) less than 40kg/m2.

Exclusion Criteria

• 1. Patient refusal. 2. Hepatic and renal insufficiency. 3. Unstable cardiovascular or pulmonary disease. 4. History of psychiatric and cognitive disorders. 5. Patients with known sensitivity or contraindications to the drug used. 6. Patients on regular opioid consumption.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 70 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Cairo University

OTHER

Sponsor Role: lead

Responsible Party

Abeer Ahmed, MD

Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Abeer Ahmed Mohamed

Maadi, Cairo Governorate, Egypt

Site Status: RECRUITING

Kasr Alainy Faculty of Medicine - Cairo university

Cairo, , Egypt

Site Status: RECRUITING

Countries

Egypt

Central Contacts

Abeer A Mohamed

Role: CONTACT

abeer_ahmed@kasralainy.edu.eg

01005244590

Facility Contacts

Abeer Ahmed, MD

Role: primary

abeer_ahmed@kasralainy.edu.eg

01005244590

Abeer Ahmed, MD

Role: primary

Other Identifiers

MS-389-2024

Identifier Type: -

Identifier Source: org_study_id