Bilateral External Oblique Intercostal Plane Bock (EOIPB) in Upper Abdominal Surgeries

NCT ID: NCT07055438

Last Updated: 2025-12-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-07-24

Study Completion Date

2025-11-16

Brief Summary

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The current study is designed to investigate the analgesic potentials of two modalities of abdominal blocks where local anesthetics is injected in the fascial planes of the abdominal muscles to anesthetize the nerves supplying the abdomen in patients undergoing upper abdomial surgeries.

the two modalities are the rectus sheath block (RSB) and the external oblique intercostal plane block (EOIPB). The investigators are going to use the ultrasound to identify the muscles and inject the local anesthetics. The investigators suggest that the EOIPB might provide better pain control when compared to RSB.

Detailed Description

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Fascial plane blocks emerge as an appealing technique to provide good intraoperative and postoperative analgesia in patients undergoing upper abdominal surgeries. Such techniques have the benefit of decreasing opioids use and consequently reducing the like hood of their side effects.

Ultrasound guided rectus sheath Block (RSB) targets the terminal branches of thoracic nerves thus providing analgesia for midline abdominal incisions.

Ultrasound guided external oblique intercostal plane block (EOIPB), a relatively new technique, targets the lateral cutaneous branches of the thoracoabdominal nerves providing analgesia for anterolateral and upper median plane of the abdomen.

Studies Comparing both techniques are deficient, that is why the investigators designed the current study to evaluate and compare the analgesic efficacy of both techniques in upper abdominal surgeries namely Whipple operation and total gastrectomy.

The study is a randomized controlled double blinded trial comprising two groups. The RSB group will receive bilateral ultrasound guided rectus sheath block with 20ml of 0.25% bupivacaine on each side. The EOIB group will receive bilateral ultrasound guided External oblique intercostal plane block with 20ml of 0.25% bupivacaine on each side as well. Both blocks will be performed after administering general anesthesia.

The main endpoint of the study is the time to first request for rescue analgesia.

Conditions

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Post Operative Analgesia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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RSB

Bilateral rectus sheath block for patients undergoing upper abdominal surgeries

Group Type ACTIVE_COMPARATOR

Ultrasound guided Rectus sheath block

Intervention Type PROCEDURE

After receiving general anesthesia, bilateral ultrasound guided rectus sheath block with 20 ml of 0.25% bupivacaine on each side will be administered to 20 patients undergoing upper abdominal surgeries namely whipple operation and total gastrectomy

EOIPB

Bilateral External oblique intercostal plane block for patients undergoing upper abdominal surgeries

Group Type EXPERIMENTAL

ultrasound guided external oblique intercostal plane block

Intervention Type PROCEDURE

After receiving general anesthesia, bilateral ultrasound guided external oblique intercostal plane block with 20 ml of 0.25% bupivacaine on each side will be administered to 20 patients undergoing upper abdominal surgeries namely whipple operation and total gastrectomy

Interventions

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Ultrasound guided Rectus sheath block

After receiving general anesthesia, bilateral ultrasound guided rectus sheath block with 20 ml of 0.25% bupivacaine on each side will be administered to 20 patients undergoing upper abdominal surgeries namely whipple operation and total gastrectomy

Intervention Type PROCEDURE

ultrasound guided external oblique intercostal plane block

After receiving general anesthesia, bilateral ultrasound guided external oblique intercostal plane block with 20 ml of 0.25% bupivacaine on each side will be administered to 20 patients undergoing upper abdominal surgeries namely whipple operation and total gastrectomy

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age from 18 to 65 Years
* Both sexes.
* American Society of Anesthesiologists (ASA) physical status II, III.
* Patients who will undergo upper abdominal surgeries (Whipple operation, total gastrectomy).

Exclusion Criteria

* Coagulation disorders.
* Abdominal surgery history.
* Infection in the block application area.
* Chronic opioid use.
* Local anesthetic (LA) allergy.
* Pregnancy.
* BMI ≥35 kg/m2.
* Severe cardiovascular problems.
* Diabetic neuropathy.
* Complicated surgeries with massive blood loss and hemodynamic instability.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Kasr El Aini Hospital

OTHER

Sponsor Role lead

Responsible Party

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Rania Samir Fahmy

Associate professor of Anesthesia, intesive care and pain management - Kasr El Aini Hospital

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Mohamed Abd El Fattah, Associate professor

Role: PRINCIPAL_INVESTIGATOR

National Cancer Institute, Egypt

Locations

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Kasr El Ainy

Cairo, , Egypt

Site Status

National Cancer institute

Cairo, , Egypt

Site Status

Countries

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Egypt

References

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Elsharkawy H, Kolli S, Soliman LM, Seif J, Drake RL, Mariano ER, El-Boghdadly K. The External Oblique Intercostal Block: Anatomic Evaluation and Case Series. Pain Med. 2021 Nov 26;22(11):2436-2442. doi: 10.1093/pm/pnab296.

Reference Type RESULT
PMID: 34626112 (View on PubMed)

Ohgoshi Y, Kawagoe I, Ando A, Ikegami M, Hanai S, Ichimura K. Novel external oblique muscle plane block for blockade of the lateral abdominal wall: a pilot study on volunteers. Can J Anaesth. 2022 Oct;69(10):1203-1210. doi: 10.1007/s12630-022-02310-4. Epub 2022 Aug 23.

Reference Type RESULT
PMID: 35999334 (View on PubMed)

Abdildin Y, Tapinova K, Salamat A, Shaimakhanov R, Aitbayev A, Viderman D. Rectus Sheath Block in Abdominal Surgery: A Systematic Review with Meta-Analysis. Rom J Anaesth Intensive Care. 2023 Apr 20;30(1):43-50. doi: 10.2478/rjaic-2023-0006. eCollection 2023 Apr.

Reference Type RESULT
PMID: 37635853 (View on PubMed)

Cho S, Kim YJ, Jeong K, Moon HS. Ultrasound-guided bilateral rectus sheath block reduces early postoperative pain after laparoscopic gynecologic surgery: a randomized study. J Anesth. 2018 Apr;32(2):189-197. doi: 10.1007/s00540-018-2457-0. Epub 2018 Feb 8.

Reference Type RESULT
PMID: 29423579 (View on PubMed)

Howle R, Ng SC, Wong HY, Onwochei D, Desai N. Comparison of analgesic modalities for patients undergoing midline laparotomy: a systematic review and network meta-analysis. Can J Anaesth. 2022 Jan;69(1):140-176. doi: 10.1007/s12630-021-02128-6. Epub 2021 Nov 5.

Reference Type RESULT
PMID: 34739706 (View on PubMed)

Other Identifiers

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MS-185-2024

Identifier Type: -

Identifier Source: org_study_id

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