Ultrasound Guided Erector Spinae Plane Block vs External Oblique Intercostal Plane Block for Nephrectomy

Not Applicable

Completed

• Conditions: Post Operative Pain
• Interventions: Procedure: external oblique intercostal block; Procedure: Erector Spine block

• Registration Number: NCT06048744
• Lead Sponsor: Menoufia University

Brief Summary

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

Group A: will receive U S guided external oblique intercostal block after induction.

Group B:

Patients will receive US guided erector spine block after induction.

Detailed Description

Patients will be premedicated with IV midazolam (0.05 mg/kg). Under standard monitoring including Electrocardiography, Non-Invasive Blood Pressure, and Pulse Oximetry. General Anesthesia will be induced with Fentanyl (1-2 μg/kg), Propofol (2-3 mg/kg), and Atracurium (0.5-0.8 mg/kg). Pressure controlled Volume guarantee Ventilation mode will be used to maintain O2 Saturation Above 98%. Anesthesia will be maintained with Isoflurane 1.2 Minimum Alveolar Concentration inhalation

Study Timeline

• Study Start: 2023-09-01
• Study First Submitted: 2023-09-11
• Study First Submitted QC: 2023-09-20
• Study First Posted: 2023-09-21
• Primary Completion: 2023-12-20
• Status Verified: 2024-01
• Last Update Submitted: 2024-01-24
• Study Completion: 2024-01-25
• Last Update Posted: 2024-01-26

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 25

Inclusion Criteria

• Eligible patients will be older than 21 years old with American society of anesthesiology ASA physical status I& II&III scheduled for elective (Subcostal) Nephrectomy

Exclusion Criteria

• Patients who are:
• Uncooperative.
• Having allergy to any of the study drugs.
• Known abuse of alcohol or medication.
• Having Local infection at the site of injection or systemic infection.
• Pregnancy.
• With coagulation disorders or on anticoagulation therapy.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
external oblique intercostal block	external oblique intercostal block	After induction of general anesthesia, external oblique intercostal blocks will be performed with patients positioned in the supine position with their ipsilateral arm abducted. A 14-15 MHz linear ultrasound transducer (Sono-Site) was placed in the sagittal plane between the midclavicular and anterior axillary lines at the level of sixth rib. 30 ml of bupivacaine 0.25% will be administered incrementally. The drug will be injected after a negative aspiration into the plane deep to the external oblique muscle and superficial to the sixth and seventh ribs and their associated intercostal muscles.
Erector Spine Block	Erector Spine block	After induction of general anesthesia, patients will be positioned in the lateral position . A linear ultrasound transducer will be placed on the midline to identify the T8 spinous process. From this position, the ultrasound transducer was moved 2-3 cm laterally to visualize the hyperechoic line of the T8 transverse process with its associated acoustic shadow inferiorly, and the overlying erector spinae muscle superiorly. 30 ml 0.25% bupivacaine will be injected.

Primary Outcome Measures

Name	Time	Method
time for first rescue analgesia	day 0	hours

Secondary Outcome Measures

Name	Time	Method
the number of rescue analgesics	24hours	numbers'
visual analogue score VAS score	24 hours	(a scale from 0 to 10 where 0 is interpreted as no pain, 1-4 mild pain, 5-6 moderate pain, 7-10 severe pain) will be recorded 15 min after extubation (as soon as the patient will be alert enough to report pain)

Trial Locations

Locations (1)

Menoufia university; 🇪🇬 Cairo, Shibin Elkom, Egypt