Rhomboid Intercostal Sub-serratus Plane Block Versus External Oblique Intercostal Block in Open Nephrectomy
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Rhomboid intercostal subserratus plane block, External oblique intercostal block, Intravenous morphine.
- Who it may be relevant to
- Registry conditions: Rhomboid Intercostal Sub-serratus Plane Block, External Oblique Intercostal Block, Open Nephrectomy. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Egypt
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Ultrasound Guided Rhomboid Intercostal Sub-serratus Plane Block Versus External Oblique Intercostal Block in Open Nephrectomy: Randomized Controlled Study
Overview
This study aims to compare time of first request of analgesia among patients undergoing rhomboid intercostal sub-serratus plane block versus external oblique intercostal block for perioperative pain management in open nephrectomy.
Detailed description
Open nephrectomy is a common surgery usually performed for malignant and non-malignant renal pathologies. Open nephrectomy incision is associated with a high incidence of intense immediate postoperative pain and chronic pain the months following surgery.
The rhomboid intercostal block has previously been used for pain management in thoracic wall surgery.
Subserratus plane block in the treatment of post-abdominal surgical pain and the combination of the two blocks was subsequently renamed the "RISS block". The nerves targeted by the RISS block include the lateral cutaneous branches of the ventral branches of the thoracic intercostal nerves, located between the rhomboid muscle and the intercostal muscles, and deep into the scapula serratus anterior muscle. RISS block provides analgesia from T4 to T9 thoracic dermatomes and has been used in postoperative pain management for thoracic surgeries and upper abdominal surgeries.
Interventions
- Other Rhomboid intercostal subserratus plane block
Patients will receive the rhomboid intercostal subserratus plane block. - Other External oblique intercostal block
Patients will receive the external oblique intercostal block. - Drug Intravenous morphine
Patients will not receive any interventions (Intravenous morphine 0.1mg/kg after induction of general anesthesia).
Primary outcome measures
- Time of first request of analgesia [Time frame: 24 hours postoperatively]
Secondary outcome measures (6)
- Heart rate [Time frame: 24 hours postoperatively]
- Mean arterial blood pressure [Time frame: 24 hours postoperatively]
- Total amount of fentanyl [Time frame: 24 hours postoperatively]
- Total morphine consumption [Time frame: 24 hours postoperatively]
- Degree of pain [Time frame: 24 hours postoperatively]
- Incidence of block related complications [Time frame: 24 hours postoperatively]
Eligibility criteria
Inclusion criteria
- Both sexes.
- American Society of Anesthesiologists (ASA) physical status II, III.
- Body mass index (BMI): > 20 kg/ m2 and < 35 kg/ m2.
- Patients undergoing open nephrectomy.
Exclusion criteria
- Patient refusal.
- BMI <20 kg/m2 and >35 kg/m2
- Known sensitivity or contraindication to drug used in the study (local anesthetics, opioids).
- History of psychiatric and cognitive disorders or chronic pain.
- Contraindication to regional anesthesia e.g pre- existing peripheral neuropathies.
- Severe respiratory or cardiac disorders.
- Advanced liver or kidney disease.
- Pregnancy.
- Physical status ASA IV.
- Coagulopathy with INR ≥ 1.6: hereditary (e.g. hemophilia, fibrinogen abnormalities \& deficiency of factor II) - acquired (e.g. impaired liver functions with prothrombin concentration less than 60 %, vitamin K deficiency \& therapeutic anticoagulants drugs).
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Open label
- Primary purpose
- Treatment
Study locations
Egypt · 1 center
- Cairo University — Cairo
Identifiers
NCT: NCT07642193 · AP2604-501-160-209