QL Block Versus EO Plane Block for Analgesia After Open Nephrectomy

NCT07787221 | Recruiting

• 1 other identifier: QL block vs EOB in nephrectomy
• Study Type: interventional
• Target: 54
• Locations: 1 country
• Sites: 2

Brief Summary

This prospective randomized clinical trial aims to compare two ultrasound-guided regional anesthesia techniques, the transmuscular quadratus lumborum (QL) block and the external oblique (EO) plane block, for pain relief after open nephrectomy. Open nephrectomy is a major surgical procedure that can cause significant postoperative pain and may require opioid medications for adequate pain control. Adult patients undergoing open nephrectomy at the National Cancer Institute, Cairo University, who meet the study eligibility criteria will be randomly assigned to receive either a QL block or an EO plane block before surgery. Both techniques will be performed under ultrasound guidance using bupivacaine in addition to standardized general anesthesia and multimodal postoperative analgesia. The main purpose of the study is to determine whether the QL block provides better postoperative analgesia than the EO plane block. The primary outcome will be the total amount of intravenous morphine consumed during the first 24 hours after surgery. Secondary outcomes will include postoperative pain scores, time to first request for rescue analgesia, hemodynamic changes, recovery time, patient satisfaction, and adverse effects related to analgesia or the regional anesthesia techniques. A total of 54 patients will be enrolled and randomly allocated equally between the two treatment groups.

Conditions

Postoperative Pain

Keywords

nephrectomy,pain ,qadratus lamborum

Outcome Measures

Primary Outcomes (1)

• 24-hour postoperative morphine consumption

  Total amount of intravenous morphine administered as rescue analgesia during the first 24 hours after surgery. Morphine consumption will be recorded for each participant and compared between the quadratus lumborum block and external oblique plane block groups.

  First 24 hours after surgery

Study Arms (2)

Quadratus Lumborum Block (QL)

EXPERIMENTAL

Participants will receive an ultrasound-guided transmuscular quadratus lumborum block before induction of general anesthesia. A total of 30 mL of 0.25% bupivacaine will be administered in the fascial plane between the quadratus lumborum and psoas major muscles. Participants will also receive the standardized general anesthesia and postoperative multimodal analgesia described in the study protoco

Procedure: Quadratus Lumborum Block (QLB)

External Oblique Plane Block (EO)

EXPERIMENTAL

Participants will receive an ultrasound-guided external oblique plane block before induction of general anesthesia. A total of 30 mL of 0.25% bupivacaine will be administered in the fascial plane between the external oblique and intercostal muscles. Participants will also receive the standardized general anesthesia and postoperative multimodal analgesia described in the study protocol.

Procedure: External Oblique Plane Block

Interventions

Quadratus Lumborum Block (QLB) PROCEDURE

Ultrasound-guided transmuscular quadratus lumborum block using 30 mL of 0.25% bupivacaine administered before induction of general anesthesia.

Quadratus Lumborum Block (QL)

External Oblique Plane Block PROCEDURE

Ultrasound-guided external oblique plane block using 30 mL of 0.25% bupivacaine administered before induction of general anesthesia.

External Oblique Plane Block (EO)

Eligibility Criteria

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

You may qualify if:

• Adult patients aged 18 to 65 years. Patients undergoing open nephrectomy at the National Cancer Institute, Cairo University.
• American Society of Anesthesiologists (ASA) physical status II-III. Body mass index (BMI) greater than 20 kg/m² and less than 35 kg/m².

You may not qualify if:

• Patient refusal to participate. ASA physical status IV. Age less than 18 years or greater than 65 years. BMI less than 20 kg/m² or greater than 35 kg/m². Known allergy or contraindication to any study medication, including local anesthetics or opioids.
• History of psychiatric disorders or chronic pain. Contraindications to regional anesthesia, including local infection at the injection site, pre-existing neuropathy, or coagulopathy.
• Severe organ dysfunction, including cardiac dysfunction (ejection fraction \<40%), respiratory dysfunction (FEV1 \<50% of predicted or requirement for home oxygen therapy), hepatic dysfunction (Child-Pugh class C), or renal dysfunction (estimated glomerular filtration rate \<30 mL/min/1.73 m²).

Sponsors & Collaborators

• Cairo University: lead

Study Sites (2)

Cairo University

Cairo, 11796, Egypt

RECRUITING

Cairo University

Cairo, Egypt

RECRUITING

Related Publications (3)

• Blanco R, Ansari T, Girgis E. Quadratus lumborum block for postoperative pain after caesarean section: A randomised controlled trial. Eur J Anaesthesiol. 2015 Nov;32(11):812-8. doi: 10.1097/EJA.0000000000000299.

  PMID: 26225500 BACKGROUND

• Elsharkawy H, El-Boghdadly K, Barrington M. Quadratus Lumborum Block: Anatomical Concepts, Mechanisms, and Techniques. Anesthesiology. 2019 Feb;130(2):322-335. doi: 10.1097/ALN.0000000000002524. No abstract available.

  PMID: 30688787 BACKGROUND

• Blanco R. TAP block under ultrasound guidance: the description of a "non-pops technique." Reg Anesth Pain Med. 2007;32(2):130.

  RESULT

MeSH Terms

Conditions

Pain, Postoperative

Condition Hierarchy (Ancestors)

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

Study Officials

• Mona H Abdelhamid, MD

  Professor of anesthesia

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Sayed M Abed, MD

CONTACT

002-01226806532; sayed.abed@nci.cu.edu.eg

Nourhan R Ali Hassan, Master's

CONTACT

002-01200858194; nourhanrabeaali@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: Participants will be blinded to their assigned regional anesthesia technique. Postoperative outcomes will be assessed by an independent investigator who is blinded to group allocation. The anesthesiologist performing the block will not be blinded because knowledge of the assigned intervention is necessary to perform the procedure.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor of Anesthesiology and Surgical ICU and Pain Management

Model Details: Participants will be randomly assigned in a 1:1 ratio to one of two parallel intervention groups: transmuscular quadratus lumborum block or external oblique plane block.

Study Record Dates

• First Submitted: August 24, 2026
• First Posted: August 26, 2026
• Study Start: April 1, 2026
• Primary Completion (Estimated): April 1, 2027
• Study Completion (Estimated): May 1, 2027
• Last Updated: August 26, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

EG (2)