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

NCT07055438 | Completed

• 1 other identifier: MS-185-2024
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 2

Brief Summary

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.

Conditions

Post Operative Analgesia

Keywords

Rectus shealth block; External oblique intercostal plane block

Outcome Measures

Primary Outcomes (1)

• Time to first request for rescue analgesia

  Time from end of surgery to first dose of morphine administered

  Time in hours from end of surgery to first dose of morphine administered up to 24 hours postoperatively

Secondary Outcomes (5)

• Fentanyl consumption

  From the start of the surgery till the end in micogram/Kg

• Postoperative morphine consumption

  from the time numerical rating scale exceeds 3 and till 24 hours after the end of the surgery

• Pain score

  from the time of recovery immediately in the postoperative period and then at 30 minutes, 1 hour, 2 hours, 4 hours, 6 hours, 12 hours and 24 hours postoperatively

• Patient satisfaction of analgesia

  2 hours after recovery from anesthesia

• Incidence of postoperative nausea and vomiting

  From the recovery of anesthesia and up to 24 hours postoperatively

Study Arms (2)

RSB

ACTIVE COMPARATOR

Bilateral rectus sheath block for patients undergoing upper abdominal surgeries

Procedure: Ultrasound guided Rectus sheath block

EOIPB

EXPERIMENTAL

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

Procedure: ultrasound guided external oblique intercostal plane block

Interventions

Ultrasound guided Rectus sheath block 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

RSB

ultrasound guided external oblique intercostal plane block 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

EOIPB

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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).

You may not qualify if:

• 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.

Sponsors & Collaborators

• Kasr El Aini Hospital: lead

Study Sites (2)

Kasr El Ainy

Cairo, Egypt

Location

National Cancer institute

Cairo, Egypt

Location

Related Publications (5)

• 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.

  PMID: 34626112 RESULT

• 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.

  PMID: 35999334 RESULT

• 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.

  PMID: 37635853 RESULT

• 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.

  PMID: 29423579 RESULT

• 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.

  PMID: 34739706 RESULT

Study Officials

• Mohamed Abd El Fattah, Associate professor

  National Cancer Institute, Egypt

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate professor of Anesthesia, intesive care and pain management - Kasr El Aini Hospital

Study Record Dates

• First Submitted: June 15, 2025
• First Posted: July 8, 2025
• Study Start: July 24, 2025
• Primary Completion: November 16, 2025
• Study Completion: November 16, 2025
• Last Updated: December 2, 2025

Record last verified: 2025-11

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP
• Time Frame: IPD can be available 2 months after completion of the study
• Access Criteria: IPD can be accessed from the authors by journals considering the study for publication and upon reasonable request from other investigators

Locations

EG (2)