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

Not Applicable
Completed
Conditions
Postoperative Pain
Interventions
Procedure: external oblique intercostal block
Registration Number
NCT06056479
Lead Sponsor
Menoufia University
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.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
25
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

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
external oblique intercostal block after inductionexternal oblique intercostal blockAfter 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.
Primary Outcome Measures
NameTimeMethod
Time for first rescue analgesiaday 0

hours

Secondary Outcome Measures
NameTimeMethod
VAS score24 hours

1 to 10 (0 is interpreted as no pain, 1-4 mild pain, 5-6 moderate pain, 7-10 severe pain)

rescue analgesics24hous

morphine mg

Trial Locations

Locations (1)

Menoufia university

🇪🇬

Cairo, Shibin Elkom, Egypt

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