Dual Approach External Oblique Fascial Plane Block Versus Erector Spinae Plane Block for Post Operative Analgesia in Percutaneous Nephrolithotomy

NCT07359391 | Not Yet Recruiting

• 1 other identifier: ZU_IRB# 1985 /13-Jan-2026
• Study Type: interventional
• Target: 90
• Locations: 0 countries
• Sites: N/A

Brief Summary

Here is a \*\*patient-friendly, ClinicalTrials.gov-compliant Brief Summary\*\* written in \*\*plain language\*\*, avoiding technical jargon as much as possible while remaining accurate. You can \*\*copy-paste this directly\*\* into the \*\*Brief Summary\*\* field.

• \*\*Brief Summary\*\* Percutaneous nephrolithotomy (PCNL) is a common surgical procedure used to remove large kidney stones. Patients often experience moderate to severe pain after this surgery due to the surgical incision and irritation of the kidney and surrounding tissues. Effective pain control after PCNL is important to improve patient comfort, reduce the need for opioid medications, and enhance recovery. Several regional anesthesia techniques have been developed to reduce postoperative pain. Two of these techniques are the dual-approach external oblique fascial plane block and the erector spinae plane block. Both techniques involve injecting a local anesthetic near specific muscle planes using ultrasound guidance to reduce pain signals from the surgical area. However, it is not yet clear which of these two techniques provides better pain relief after PCNL. This study aims to compare the effectiveness of the dual-approach external oblique fascial plane block and the erector spinae plane block in controlling pain after PCNL surgery. Adult patients scheduled for PCNL will be randomly assigned to receive one of the two nerve block techniques or standard general anesthesia alone. Pain levels, additional pain medication requirements, patient satisfaction, and any block-related complications will be assessed during the first 24 hours after surgery. The results of this study may help determine the most effective regional anesthesia technique for improving postoperative pain management in patients undergoing PCNL.

Conditions

Kidney Stones

Keywords

Percutaneous Nephrolithotomy; Postoperative Analgesia; Dual Approach External Oblique Fascial Plane Block; Erector Spinae Plane Block; Pain Management

Outcome Measures

Primary Outcomes (1)

• Postoperative Pain Intensity

  Postoperative pain will be assessed using the Visual Analog Scale (VAS; 0-10), where 0 indicates no pain and 10 indicates the worst imaginable pain, measured at predefined time points during the first 24 hours after surgery.

  First 24 hours postoperatively

Study Arms (3)

Arm Name: Dual External Oblique Fascial Plane Block Arm Type: Experimental

EXPERIMENTAL

Participants receive ultrasound-guided dual-approach (lateral and costal) external oblique fascial plane block in addition to standard general anesthesia for percutaneous nephrolithotomy.

Procedure: Dual External Oblique Fascial Plane Block

Erector Spinae Plane Block

EXPERIMENTAL

Participants receive ultrasound-guided erector spinae plane block in addition to standard general anesthesia for percutaneous nephrolithotomy.

Procedure: Erector Spinae Plane Block

General Anesthesia Only

ACTIVE COMPARATOR

articipants receive routine general anesthesia according to institutional standard analgesic protocol without the addition of any regional anesthesia technique.

Procedure: General Anesthesia

Interventions

Erector Spinae Plane Block PROCEDURE

Ultrasound-guided erector spinae plane block performed with local anesthetic in addition to standard general anesthesia for percutaneous nephrolithotomy.

Erector Spinae Plane Block

Dual External Oblique Fascial Plane Block PROCEDURE

Ultrasound-guided dual-approach (lateral and costal) external oblique fascial plane block performed using local anesthetic in addition to standard general anesthesia for percutaneous nephrolithotomy.

Arm Name: Dual External Oblique Fascial Plane Block Arm Type: Experimental

General Anesthesia PROCEDURE

Routine general anesthesia according to institutional standard anesthetic and analgesic protocol without the addition of any regional anesthesia technique.

General Anesthesia Only

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 between 18 and 65 years
• American Society of Anesthesiologists (ASA) physical status I or II
• Body mass index (BMI) between 18 and 35 kg/m²
• Scheduled for unilateral percutaneous nephrolithotomy (PCNL)
• Ability to understand the study protocol and provide written informed conse

You may not qualify if:

• Known allergy or hypersensitivity to local anesthetics
• Infection at the site of block injection
• Coagulopathy or bleeding disorders
• Chronic pain syndrome or long-term opioid use
• Severe hepatic, renal, or cardiac disease

Sponsors & Collaborators

• Zagazig University: lead

MeSH Terms

Conditions

Kidney Calculi; Agnosia

Interventions

Anesthesia, General

Condition Hierarchy (Ancestors)

Nephrolithiasis; Kidney Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Urolithiasis; Urinary Calculi; Male Urogenital Diseases; Calculi; Pathological Conditions, Anatomical; Pathological Conditions, Signs and Symptoms; Perceptual Disorders; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms

Intervention Hierarchy (Ancestors)

Anesthesia; Anesthesia and Analgesia

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: Participants and postoperative outcome assessors are blinded to group allocation. Randomization is performed using sealed opaque envelopes opened by an anesthesiologist not involved in postoperative assessment. The anesthesiologist performing the block is not blinded due to the nature of the interventions.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Lecturer of Anesthesia, Intensive Care, and Pain Management

Study Record Dates

• First Submitted: January 14, 2026
• First Posted: January 22, 2026
• Study Start: January 12, 2026
• Primary Completion (Estimated): August 1, 2026
• Study Completion (Estimated): August 1, 2026
• Last Updated: January 22, 2026

Record last verified: 2026-01