Ultrasound-Guided Erector Spinae Plane Block Versus Modified Thoracoabdominal Block for Analgesia in Obese Patients

NCT06841783 | Completed

• 1 other identifier: MS-375-2023
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Obesity is a complex chronic disease that has become a major public health concern worldwide, with the prevalence of obesity increasing dramatically over the past few decades. Patients with morbid obesity pose a challenge for perioperative pain management. High ceiling analgesics-opioids have limited role due to safety concerns for patients with or without obstructive sleep apnea . Insufficient postoperative pain management can have negative effects on recovery and quality of life, as well as limit patient comfort and delay the patient's ability to return to work after surgery . Due to the numerous negative side effects of opioid drugs, including physical dependence, nausea, vomiting, and respiratory depression and subsequent airway obstruction, the Enhanced Recovery after Surgery (ERAS) guidelines for bariatric surgery currently advise opioid reduction in this procedure. Ultrasound-guided erector spinae plane block (ESPB) and modified thoracoabdominal nerve block (M-TAPA) are both regional anesthesia techniques used to provide perioperative analgesia for obese patients undergoing LSG . The ESPB targets the spinal nerves as they exit the erector spinae muscle, providing analgesia to the abdominal wall and paraspinal muscles. The technique has shown promising results in various surgical procedures and has a low risk of complications. By blocking the spinal nerves, the ESPB can provide effective pain relief in the postoperative period for patients undergoing LSG . On the other hand, the M-TAPA targets the thoracic intercostal nerves and the abdominal wall, providing analgesia to these areas. The technique has been shown to provide effective perioperative analgesia in patients undergoing LSG. With or without ultrasound guidance, the use of M-TAPA can provide effective pain relief and reduce the need for opioid medication in the postoperative period. This study aimed to compare the analgesic effect of ultrasound guided modified thoracoabdominal nerve block and an erector spinae plain block in patients undergoing LGS

Conditions

Obesity, Morbid

Outcome Measures

Primary Outcomes (1)

• Time to first rescue analgesia

  it is defined as time from extubation until time to first analgesic requirement during the first 24 hours postoperatively.

  the first 24 hours postoperatively

Secondary Outcomes (1)

• The total opioid consumption

  the first 24 hours postoperatively

Study Arms (2)

Erector Spinae Plane Block

EXPERIMENTAL

Ultrasound-Guided Erector Spinae Plane Block

Procedure: nerve block

Modified Thoracoabdominal Nerve Block

EXPERIMENTAL

Ultrasound-Guided Modified Thoracoabdominal Nerve Block

Procedure: nerve block

Interventions

nerve block PROCEDURE

ultrasound guided nerve block

Erector Spinae Plane Block; Modified Thoracoabdominal Nerve Block

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• \. ASA II \& ASA III. 2. Gender both males and females 3. Age group: from 18 to 65 years old

You may not qualify if:

• Patient refusal.
• Uncooperative patients.
• Allergy to local anesthetics.
• Anatomical abnormality at injection site.
• Redo or combined cholecystectomy surgery.
• Infection at injection site.

Sponsors & Collaborators

• Kasr El Aini Hospital: lead

Study Sites (1)

Kasr Alainy

Cairo, Egypt

Location

MeSH Terms

Conditions

Obesity, Morbid

Interventions

Nerve Block

Condition Hierarchy (Ancestors)

Obesity; Overweight; Overnutrition; Nutrition Disorders; Nutritional and Metabolic Diseases; Body Weight; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Anesthesia, Conduction; Anesthesia; Anesthesia and Analgesia; Denervation; Neurosurgical Procedures; Surgical Procedures, Operative

Study Officials

• ahmed abdallah, Professor

  anesthesia department , cairo university

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: lecturer of anesthesia

Model Details: Patients will be randomly allocated by a computer-generated table into two of the study groups, the randomization sequence had been concealed in sealed opaque envelopes that will be opened by third doctor who will not participating in the study. The details of the series will be unknown to the investigators and the group assignment will kept in a set of sealed envelopes each bearing only the case number on the outside. This study will be performed by 2 anesthetists; one anesthetist who is experienced in performing the blocks that allocated to perform either Erector Spinae block or modified thoracoabdominal nerve block. According to a computer-generated sequence of random numbers and sealed envelope, and the other anesthetist will be blinded to the technique performed, and will monitor the patients intra and postoperatively.

Study Record Dates

• First Submitted: February 19, 2025
• First Posted: February 24, 2025
• Study Start: February 24, 2025
• Primary Completion: January 6, 2026
• Study Completion: January 6, 2026
• Last Updated: January 8, 2026

Record last verified: 2026-01

Locations

EG (1)