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Recruiting NCT07740382

Comparative Effects of ESP Block and EOIP Block on Postoperative Respiratory Recovery Following Liver Resection

No phase Interventional Liver Resection Upper Abdominal Surgeries

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: Ultrasound-guided bilateral external oblique intercostal plane (EOIP) block, Ultrasound-guided bilateral erector spinae plane (ESP) block.
Who it may be relevant to
Registry conditions: Liver Resection, Upper Abdominal Surgeries. Basic parameters: 18 years — 75 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

Comparative Effects of Erector Spinae Plane Block and External Oblique Intercostal Plane Block on Postoperative Respiratory Recovery Following Liver Resection: A Randomized Controlled Trial

Overview

This study evaluates respiratory recovery as a multidimensional construct using clinically relevant and measurable parameters, including LUS, diaphragmatic excursion, oxygen requirement, and PPCs. The investigators hypothesize that bilateral ESP block improves postoperative respiratory function compared with EOIP block following open hepatic surgery. The investigators further hypothesize that this improvement is mediated, in part, by superior analgesia.

Interventions

  • Procedure Ultrasound-guided bilateral external oblique intercostal plane (EOIP) block
    Bilateral ESP block * after induction of general anesthesia and before surgical incision. * T7 or T8 transverse process, selected consistently by protocol. * high-frequency linear probe when feasible; curvilinear probe in larger habitus. In-plane cranial-to-caudal or caudal-to-cranial approach to the fascial plane deep to erector spinae muscle and superficial to the transverse process. * Injectate: 20 mL of 0.25% bupivacaine per side after negative aspiration; hydrodissection used to confirm co
  • Procedure Ultrasound-guided bilateral erector spinae plane (ESP) block
    An ultrasound-guided bilateral ESP block will be performed after induction of general anaesthesia and before surgical incision. The block will be administered at the T7 or T8 transverse process using an in-plane ultrasound-guided approach. Twenty millilitres of 0.25% bupivacaine will be injected on each side into the fascial plane deep to the erector spinae muscle and superficial to the transverse process after negative aspiration. Correct spread of local anaesthetic will be confirmed by hydrodi

Primary outcome measures

  • Right diaphragmatic excursion [Time frame: Baseline, and 1, 6, and 24 hours after surgery.]
Secondary outcome measures (5)
  • Mean postoperative pain intensity at rest, during coughing or deep breathing [Time frame: Pain scores at rest (PACU 30 minutes, 2, 6, 12, and 24 hours) and during coughing or deep breathing (6, 12, and 24 hours).]
  • Mean cumulative postoperative opioid consumption and Mean intraoperative opioid consumption [Time frame: First 24 postoperative hours.]
  • Number of participants requiring supplemental oxygen [Time frame: First 24 postoperative hours.]
  • Number of participants with early postoperative pulmonary complications [Time frame: Within 7 postoperative days.]
  • Mean lung ultrasound score [Time frame: During the first 24 postoperative hours at predefined assessment time points.]

Eligibility criteria

Inclusion criteria

  • Adult patients aged 18-75 years
  • Adult with American Society of Anesthesiologists (ASA) physical status I-III
  • Scheduled for elective hepatic surgery via upper abdominal incisions will be eligible.
  • All participants will be required to understand the Numeric Rating Scale (NRS) and provide informed consent.

Exclusion criteria

  • Patient refusal
  • Coagulopathy (INR>1.4 or platelet count<8 x 104)
  • Contraindications to fascial plane blocks
  • Infection at the puncture site
  • Known allergy to study medications
  • Chronic opioid use or chronic pain syndromes
  • Severe chronic respiratory failure requiring home oxygen or noninvasive ventilation
  • Pregnancy
  • Body mass index>40 kg/m²
  • When ultrasound imaging will be deemed unreliable
  • Emergency surgery
  • Hemodynamic instability
  • Reoperation during the same hospital admission.
  • Patients scheduled preoperatively for elective postoperative mechanical ventilation or planned ICU intubation.

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
Quadruple blind
Primary purpose
Diagnostic

Study locations

Egypt · 1 center
  • National Liver Institute, Menoufia University — Alexandria

Identifiers

NCT: NCT07740382 · NLI IRB 00014014/ FWA00034015

Primary sources (government registries)

View this study on ClinicalTrials.gov ↗