Investigating the Analgesic Efficacy and Ease of Perfomance of Modified Throracoabdominal Plane Block and Comparing it With Erector Spinea Plane Block in Laparacopic Sleeve Gasterctomy Surgeries

NCT07654556 | Not Yet Recruiting DMC

• 1 other identifier: MD-79-2026
• Study Type: interventional
• Target: 64
• Locations: 0 countries
• Sites: N/A

Brief Summary

Interest in surgical weight loss interventions continues to rise in the face of what has been dubbed the obesity epidemic. The most popular of these weight loss interventions is laparoscopic sleeve gastrectomy, which has proven to reduce morbidity and mortality of morbidly obese patients. The aim of effective perioperative pain management extends beyond increased patient comfort and includes reduced recumbency period, enhanced recovery, reduced hospital stay, and lowers postoperative complication rates. Effective postoperative pain management has traditionally relied on multimodal strategies that combine systemic opioids, non-opioid medications, and regional anesthesia. Despite their efficacy, opioids are associated with a range of undesirable effects, such as nausea, vomiting, sedation, pruritus, and respiratory depression, which may impede early mobilization and recovery. These concerns have accelerated the adoption of ultrasound-guided regional anesthesia techniques as part of Enhanced Recovery After Surgery (ERAS) protocols, delivering superior pain control with fewer systemic adverse effects.

Conditions

Postoperative Pain

Outcome Measures

Primary Outcomes (1)

• Postoperative Visual Analogue Score

  Measurment of postoperative Visual Analogue Score, which is a scale from 0 to 10 in which 0 indicates no pain while 10 denotes unbearable pain, this will be done after 48 hours.

  48 hours

Study Arms (2)

Modified thoracoabdominal plane block through perichondrial approach (M-TAPA)

ACTIVE COMPARATOR

The M-TAPA block will be performed after induction of general anaethesia, with total volume of 25ml of 0.25% bupivacaine.

Drug: Bupivacaine 0.25% (isobaric)

Erector Spinea plane block (ESP block)

ACTIVE COMPARATOR

The ESP block will be performed after induction of general anaethesia , with total volume of 40 ml of 0.25% bupivacaine.

Drug: Bupivaciane 0.25% (Isobaric)

Interventions

Bupivacaine 0.25% (isobaric) DRUG

A bilateral injection of 25 ml of 0.25% bupivacaine will be injected as a part of ultrasound guided M-TAPA block.

Modified thoracoabdominal plane block through perichondrial approach (M-TAPA)

Bupivaciane 0.25% (Isobaric) DRUG

A bilateral injection of 25 ml of 0.25% bupivacaine will be injected as a part of ultrasound guided ESP block.

Erector Spinea plane block (ESP block)

Eligibility Criteria

• Age: 18 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Patients from both sexes.
• to 60 years old.
• ASA physical status II-III scheduled for laparoscopic sleeve gastrectomy.
• Patients with BMI (40-50) kg/ m2

You may not qualify if:

• Patient Refusal
• Lack of patient cooperation.
• Patients with any contraindication to regional nerve blocks as coagulopathy or infection at site of injection
• Patients with anatomical abnormalities at site of injection
• Patients with known hypersensitivity to bupivacaine, or any of the used drugs.
• Patients with pre-existing neurological disorder
• Patients with chronic pain syndromes including fibromyalgia, complex regional pain syndrome (CRPS), or chronic pain requiring long-term opioid or neuropathic pain medications.
• Patients with history of long-acting opioids, steroids, anticonvulsants perioperatively.

Sponsors & Collaborators

• Cairo University: lead

MeSH Terms

Conditions

Pain, Postoperative

Interventions

Bupivacaine

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Intervention Hierarchy (Ancestors)

Anilides; Amides; Organic Chemicals; Aniline Compounds; Amines

Central Study Contacts

Hesham khedr Prof. Dr., Professor

CONTACT

01001622640; hkhishamkhedr@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Doctor

Study Record Dates

• First Submitted: June 13, 2026
• First Posted: June 17, 2026
• Study Start: July 1, 2026
• Primary Completion (Estimated): March 30, 2027
• Study Completion (Estimated): March 30, 2027
• Last Updated: June 18, 2026

Record last verified: 2026-06