Modified External Oblique Intercostal Plane Block Versus Erector Spinae Plane Block for 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: Erector Spinae Plane Block, Modified External Oblique Intercostal Plane Block.
- Who it may be relevant to
- Registry conditions: Postoperative Pain, Open Nephrectomy. Basic parameters: 18 years — 65 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
- Turkey (Türkiye)
- 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
Comparison of Modified External Oblique Intercostal Plane Block and Erector Spinae Plane Block for Postoperative Analgesia in Patients Undergoing Open Nephrectomy: A Prospective Randomized Controlled Trial
Overview
This prospective, randomized, assessor-blinded clinical trial aims to compare the postoperative analgesic efficacy of ultrasound-guided Erector Spinae Plane Block (ESPB) and Modified External Oblique Intercostal Plane Block (EOIPB) in patients undergoing elective open nephrectomy under general anesthesia. Sixty adult patients will be randomized to receive either ESPB or EOIPB before surgical incision. All participants will receive standardized general anesthesia and postoperative multimodal analgesia. Postoperative pain scores, opioid consumption, rescue analgesic requirements, and postoperative nausea and vomiting will be assessed during the first 24 hours after surgery. The study aims to determine whether one fascial plane block technique provides superior postoperative pain control and recovery following open nephrectomy.
Detailed description
Open nephrectomy is associated with substantial postoperative pain that may impair recovery, delay mobilization, and increase opioid consumption. Regional anesthesia techniques have become important components of multimodal analgesia strategies aimed at improving postoperative outcomes while minimizing opioid-related adverse effects.
The erector spinae plane block (ESPB) and modified external oblique intercostal plane block (EOIPB) are ultrasound-guided fascial plane blocks that have demonstrated effectiveness in providing thoracoabdominal analgesia. However, evidence directly comparing these techniques in patients undergoing open nephrectomy remains limited.
This study is a prospective, randomized, controlled, assessor-blinded clinical trial conducted at a single tertiary academic center. Sixty patients aged 18 to 65 years with ASA physical status I-II who are scheduled for elective open nephrectomy will be enrolled and randomized in a 1:1 ratio to one of two study groups.
Participants assigned to the ESPB group will receive an ultrasound-guided erector spinae plane block with 30 mL of 0.25% bupivacaine after induction of general anesthesia and before surgical incision. Participants assigned to the EOIPB group will receive an ultrasound-guided modified external oblique intercostal plane block using the same volume and concentration of local anesthetic.
All patients will receive standardized general anesthesia, postoperative intravenous patient-controlled analgesia with tramadol, scheduled paracetamol, and rescue analgesics according to institutional protocols. Patients will be followed in the post-anesthesia care unit and at postoperative 2, 6, 12, and 24 hours.
The primary objective is to compare postoperative pain intensity between the two groups during the first 24 postoperative hours. Secondary objectives include comparison of opioid consumption, rescue analgesic requirements, postoperative nausea and vomiting, and perioperative hemodynamic parameters.
The results of this study may help identify the optimal regional analgesia technique for patients undergoing open nephrectomy and contribute to enhanced postoperative recovery.
Interventions
- Procedure Erector Spinae Plane Block
Ultrasound-guided erector spinae plane block performed after induction of general anesthesia using 30 mL of 0.25% bupivacaine before surgical incision. - Procedure Modified External Oblique Intercostal Plane Block
Ultrasound-guided modified external oblique intercostal plane block performed after induction of general anesthesia using 30 mL of 0.25% bupivacaine before surgical incision.
Primary outcome measures
- Pain intensity at rest [Time frame: 0, 2, 6, 12, and 24 hours after surgery]
Secondary outcome measures (6)
- Pain intensity during movement [Time frame: 0, 2, 6, 12, and 24 hours after surgery]
- Total Opioid Consumption [Time frame: 24 hours after surgery]
- Rescue Analgesic Requirement [Time frame: 24 hours after surgery]
- Postoperative Nausea and Vomiting [Time frame: 24 hours after surgery]
- Heart Rate [Time frame: From induction of anesthesia until the end of surgery]
- Mean Arterial Pressure [Time frame: From induction of anesthesia until the end of surgery]
Eligibility criteria
Inclusion criteria
- Age between 18 and 65 years.
- American Society of Anesthesiologists (ASA) physical status I or II.
- Scheduled for elective open nephrectomy.
- Able and willing to provide written informed consent.
- Willing to comply with study procedures.
Exclusion criteria
- Refusal to participate or inability to provide informed consent.
- Emergency surgery.
- Body mass index (BMI) greater than 35 kg/m².
- Known allergy or hypersensitivity to local anesthetics.
- Infection at the planned block insertion site.
- Coagulopathy or ongoing anticoagulant therapy.
- Pregnancy or breastfeeding.
- Prisoners or other vulnerable populations unable to provide independent consent.
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
- Double blind
- Primary purpose
- Treatment
Study locations
Turkey (Türkiye) · 1 center
- Tekirdağ Namık Kemal University — Tekirdağ
Identifiers
NCT: NCT07726550 · TNKU-EOIPB003