Post Operative AnalgesiaNCT07055438
Bilateral External Oblique Intercostal Plane Bock (EOIPB) in Upper Abdominal Surgeries
A study testing Ultrasound guided Rectus sheath block and ultrasound guided external oblique intercostal plane block in people with Post Operative Analgesia, run by Kasr El Aini Hospital at 2 sites in Egypt.
Trial summary
The current study is designed to investigate the analgesic potentials of two modalities of abdominal blocks where local anesthetics is injected in the fascial planes of the abdominal muscles to anesthetize the nerves supplying the abdomen in patients undergoing upper abdomial surgeries. Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Post Operative Analgesia
- What is being tested?
- Ultrasound guided Rectus sheath block and ultrasound guided external oblique intercostal plane block
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 40 participants
- Where
- 2 sitesEgypt
- Study dates
- 24 Jul 2025to 16 Nov 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age from 18 to 65 Years
- Both sexes.
- American Society of Anesthesiologists (ASA) physical status II, III.
- Patients who will undergo upper abdominal surgeries (Whipple operation, total gastrectomy).
Who cannot join
- Coagulation disorders.
- Abdominal surgery history.
- Infection in the block application area.
- Chronic opioid use.
- Local anesthetic (LA) allergy.
- Pregnancy.
Show all 10Show fewer
- BMI ≥35 kg/m2.
- Severe cardiovascular problems.
- Diabetic neuropathy.
- Complicated surgeries with massive blood loss and hemodynamic instability.
Trial locations and contacts
2 sites in 1 country.
About this study
Official title: Analgesic Efficacy of Ultrasound Guided Bilateral External Oblique Intercostal Plane Block Versus Rectus Sheath Block in Upper Abdominal Surgeries: A Randomized Double-blinded Controlled Study
The current study is designed to investigate the analgesic potentials of two modalities of abdominal blocks where local anesthetics is injected in the fascial planes of the abdominal muscles to anesthetize the nerves supplying the abdomen in patients undergoing upper abdomial surgeries.
the two modalities are the rectus sheath block (RSB) and the external oblique intercostal plane block (EOIPB). The investigators are going to use the ultrasound to identify the muscles and inject the local anesthetics. The investigators suggest that the EOIPB might provide better pain control when compared to RSB.
Read the detailed description
Fascial plane blocks emerge as an appealing technique to provide good intraoperative and postoperative analgesia in patients undergoing upper abdominal surgeries. Such techniques have the benefit of decreasing opioids use and consequently reducing the like hood of their side effects.
Ultrasound guided rectus sheath Block (RSB) targets the terminal branches of thoracic nerves thus providing analgesia for midline abdominal incisions.
Ultrasound guided external oblique intercostal plane block (EOIPB), a relatively new technique, targets the lateral cutaneous branches of the thoracoabdominal nerves providing analgesia for anterolateral and upper median plane of the abdomen.
Studies Comparing both techniques are deficient, that is why the investigators designed the current study to evaluate and compare the analgesic efficacy of both techniques in upper abdominal surgeries namely Whipple operation and total gastrectomy.
The study is a randomized controlled double blinded trial comprising two groups. The RSB group will receive bilateral ultrasound guided rectus sheath block with 20ml of 0.25% bupivacaine on each side. The EOIB group will receive bilateral ultrasound guided External oblique intercostal plane block with 20ml of 0.25% bupivacaine on each side as well. Both blocks will be performed after administering general anesthesia.
The main endpoint of the study is the time to first request for rescue analgesia.
- Conditions
- Post Operative Analgesia
- Being tested
- Ultrasound guided Rectus sheath block, ultrasound guided external oblique intercostal plane block
- Keywords
- Rectus shealth block, External oblique intercostal plane block
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Ultrasound guided Rectus sheath blockProcedure or surgery
After receiving general anesthesia, bilateral ultrasound guided rectus sheath block with 20 ml of 0.25% bupivacaine on each side will be administered to 20 patients undergoing upper abdominal surgeries namely whipple operation and total gastrectomy
ultrasound guided external oblique intercostal plane blockProcedure or surgery
After receiving general anesthesia, bilateral ultrasound guided external oblique intercostal plane block with 20 ml of 0.25% bupivacaine on each side will be administered to 20 patients undergoing upper abdominal surgeries namely whipple operation and total gastrectomy
| Study group | Role | What they receive |
|---|---|---|
| RSB | Active comparator | Bilateral rectus sheath block for patients undergoing upper abdominal surgeries Receives: Procedure: Ultrasound guided Rectus sheath block |
| EOIPB | Experimental | Bilateral External oblique intercostal plane block for patients undergoing upper abdominal surgeries Receives: Procedure: ultrasound guided external oblique intercostal plane block |
What is being measured
The primary outcome is the main question the study is designed to answer.
Time to first request for rescue analgesia
Time from end of surgery to first dose of morphine administered
Measured: Time in hours from end of surgery to first dose of morphine administered up to 24 hours postoperatively
Secondary outcomes (5)
Fentanyl consumption
Intraoperative fentanyl consumption
Measured: From the start of the surgery till the end in micogram/Kg
Postoperative morphine consumption
Total morphine consumption (mg) in the first 24hrs after surgery
Measured: from the time numerical rating scale exceeds 3 and till 24 hours after the end of the surgery
Pain score
Pain score using Numerical rating Scale (NRS)between 0 and 10, Zero means no pain and ten means the worst pain
Measured: from the time of recovery immediately in the postoperative period and then at 30 minutes, 1 hour, 2 hours, 4 hours, 6 hours, 12 hours and 24 hours postoperatively
Patient satisfaction of analgesia
Degree of patient satisfaction will be assessed on a 5-point Likert scale patient satisfaction (1, extremely dissatisfied; 2, unsatisfied; 3, neutral; 4, satisfied ; 5, extremely satisfied)
Measured: 2 hours after recovery from anesthesia
Incidence of postoperative nausea and vomiting
The number of patients suffering from postoperative nausea and vomiting in both groups
Measured: From the recovery of anesthesia and up to 24 hours postoperatively
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 Jul 2025
- Study start24 Jul 2025
- Primary completion16 Nov 2025
- Study completion16 Nov 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for Post Operative AnalgesiaStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 40 participants (actual)
Sponsor and investigators
- Lead sponsor
- Kasr El Aini Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Rania Samir Fahmy, Kasr El Aini Hospital
- Investigators
- Mohamed Abd El Fattah, Associate professor, Principal investigator, National Cancer Institute, Egypt
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07055438
- Sponsor's protocol ID
- MS-185-2024
- Status last verified
- Nov 2025
- First submitted
- 15 Jun 2025
- Last updated
- 2 Dec 2025
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: The detailed protocol describing the techniques used in the study and the anesthetic conduct and the outcome measures. The statistical plan to analyze the different outcome measures.
Publications
Elsharkawy H, Kolli S, Soliman LM, Seif J, Drake RL, Mariano ER, El-Boghdadly K. The External Oblique Intercostal Block: Anatomic Evaluation and Case Series. Pain Med. 2021 Nov 26;22(11):2436-2442. doi: 10.1093/pm/pnab296.
PubMed 34626112Ohgoshi Y, Kawagoe I, Ando A, Ikegami M, Hanai S, Ichimura K. Novel external oblique muscle plane block for blockade of the lateral abdominal wall: a pilot study on volunteers. Can J Anaesth. 2022 Oct;69(10):1203-1210. doi: 10.1007/s12630-022-02310-4. Epub 2022 Aug 23.
PubMed 35999334Abdildin Y, Tapinova K, Salamat A, Shaimakhanov R, Aitbayev A, Viderman D. Rectus Sheath Block in Abdominal Surgery: A Systematic Review with Meta-Analysis. Rom J Anaesth Intensive Care. 2023 Apr 20;30(1):43-50. doi: 10.2478/rjaic-2023-0006. eCollection 2023 Apr.
PubMed 37635853Cho S, Kim YJ, Jeong K, Moon HS. Ultrasound-guided bilateral rectus sheath block reduces early postoperative pain after laparoscopic gynecologic surgery: a randomized study. J Anesth. 2018 Apr;32(2):189-197. doi: 10.1007/s00540-018-2457-0. Epub 2018 Feb 8.
PubMed 29423579Howle R, Ng SC, Wong HY, Onwochei D, Desai N. Comparison of analgesic modalities for patients undergoing midline laparotomy: a systematic review and network meta-analysis. Can J Anaesth. 2022 Jan;69(1):140-176. doi: 10.1007/s12630-021-02128-6. Epub 2021 Nov 5.
PubMed 34739706
Study at a glance
From the registry record, last updated by the sponsor on 2 Dec 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Analgesic Efficacy of Ultrasound Guided Bilateral External Oblique Intercostal Plane Block Versus Rectus Sheath Block in Upper Abdominal Surgeries: A Randomized Double-blinded Controlled Study
- ClinicalTrials.gov ID
- NCT07055438
- Acronym / sponsor ID
- MS-185-2024
- Conditions
- Post Operative Analgesia
- Keywords
- Rectus shealth block, External oblique intercostal plane block
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 40 participants (actual)
- Lead sponsor
- Kasr El Aini HospitalUniversity, hospital or other
- Study start
- 24 Jul 2025 (actual)
- Primary completion
- 16 Nov 2025 (actual)
- Study completion
- 16 Nov 2025 (actual)
- First posted
- 8 Jul 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The current study is designed to investigate the analgesic potentials of two modalities of abdominal blocks where local anesthetics is injected in the fascial planes of the abdominal muscles to anesthetize the nerves supplying the abdomen in patients undergoing upper abdomial surgeries.
the two modalities are the rectus sheath block (RSB) and the external oblique intercostal plane block (EOIPB). The investigators are going to use the ultrasound to identify the muscles and inject the local anesthetics. The investigators suggest that the EOIPB might provide better pain control when compared to RSB.
Detailed description
Fascial plane blocks emerge as an appealing technique to provide good intraoperative and postoperative analgesia in patients undergoing upper abdominal surgeries. Such techniques have the benefit of decreasing opioids use and consequently reducing the like hood of their side effects.
Ultrasound guided rectus sheath Block (RSB) targets the terminal branches of thoracic nerves thus providing analgesia for midline abdominal incisions.
Ultrasound guided external oblique intercostal plane block (EOIPB), a relatively new technique, targets the lateral cutaneous branches of the thoracoabdominal nerves providing analgesia for anterolateral and upper median plane of the abdomen.
Studies Comparing both techniques are deficient, that is why the investigators designed the current study to evaluate and compare the analgesic efficacy of both techniques in upper abdominal surgeries namely Whipple operation and total gastrectomy.
The study is a randomized controlled double blinded trial comprising two groups. The RSB group will receive bilateral ultrasound guided rectus sheath block with 20ml of 0.25% bupivacaine on each side. The EOIB group will receive bilateral ultrasound guided External oblique intercostal plane block with 20ml of 0.25% bupivacaine on each side as well. Both blocks will be performed after administering general anesthesia.
The main endpoint of the study is the time to first request for rescue analgesia.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| RSB | Active comparator | Procedure: Ultrasound guided Rectus sheath blockBilateral rectus sheath block for patients undergoing upper abdominal surgeries |
| EOIPB | Experimental | Procedure: ultrasound guided external oblique intercostal plane blockBilateral External oblique intercostal plane block for patients undergoing upper abdominal surgeries |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Age from 18 to 65 Years
- Both sexes.
- American Society of Anesthesiologists (ASA) physical status II, III.
- Patients who will undergo upper abdominal surgeries (Whipple operation, total gastrectomy).
Key exclusion criteria (10 listed)
- Coagulation disorders.
- Abdominal surgery history.
- Infection in the block application area.
- Chronic opioid use.
- Local anesthetic (LA) allergy.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Ultrasound guided Rectus sheath blockAfter receiving general anesthesia, bilateral ultrasound guided rectus sheath block with 20 ml of 0.25% bupivacaine on each side will be administered to 20 patients undergoing upper abdominal surgeries namely whipple operation and total gastrectomy | Procedure or surgery | RSB |
| ultrasound guided external oblique intercostal plane blockAfter receiving general anesthesia, bilateral ultrasound guided external oblique intercostal plane block with 20 ml of 0.25% bupivacaine on each side will be administered to 20 patients undergoing upper abdominal surgeries namely whipple operation and total gastrectomy | Procedure or surgery | EOIPB |
Primary outcome
Time to first request for rescue analgesia
Time frame: Time in hours from end of surgery to first dose of morphine administered up to 24 hours postoperatively
Time from end of surgery to first dose of morphine administered
5 secondary outcomes
Fentanyl consumption
Time frame: From the start of the surgery till the end in micogram/Kg
Postoperative morphine consumption
Time frame: from the time numerical rating scale exceeds 3 and till 24 hours after the end of the surgery
Pain score
Time frame: from the time of recovery immediately in the postoperative period and then at 30 minutes, 1 hour, 2 hours, 4 hours, 6 hours, 12 hours and 24 hours postoperatively
Patient satisfaction of analgesia
Time frame: 2 hours after recovery from anesthesia
Incidence of postoperative nausea and vomiting
Time frame: From the recovery of anesthesia and up to 24 hours postoperatively
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 2 Dec 2025.
- Results publication: PubMed 34626112Elsharkawy H, Kolli S, Soliman LM, Seif J, Drake RL, Mariano ER, El-Boghdadly K. The External Oblique Intercostal Block: Anatomic Evaluation and Case Series. Pain Med. 2021 Nov 26;22(11):2436-2442. doi: 10.1093/pm/pnab296.
- Results publication: PubMed 35999334Ohgoshi Y, Kawagoe I, Ando A, Ikegami M, Hanai S, Ichimura K. Novel external oblique muscle plane block for blockade of the lateral abdominal wall: a pilot study on volunteers. Can J Anaesth. 2022 Oct;69(10):1203-1210. doi: 10.1007/s12630-022-02310-4. Epub 2022 Aug 23.
- Results publication: PubMed 37635853Abdildin Y, Tapinova K, Salamat A, Shaimakhanov R, Aitbayev A, Viderman D. Rectus Sheath Block in Abdominal Surgery: A Systematic Review with Meta-Analysis. Rom J Anaesth Intensive Care. 2023 Apr 20;30(1):43-50. doi: 10.2478/rjaic-2023-0006. eCollection 2023 Apr.
- Results publication: PubMed 29423579Cho S, Kim YJ, Jeong K, Moon HS. Ultrasound-guided bilateral rectus sheath block reduces early postoperative pain after laparoscopic gynecologic surgery: a randomized study. J Anesth. 2018 Apr;32(2):189-197. doi: 10.1007/s00540-018-2457-0. Epub 2018 Feb 8.
- Results publication: PubMed 34739706Howle R, Ng SC, Wong HY, Onwochei D, Desai N. Comparison of analgesic modalities for patients undergoing midline laparotomy: a systematic review and network meta-analysis. Can J Anaesth. 2022 Jan;69(1):140-176. doi: 10.1007/s12630-021-02128-6. Epub 2021 Nov 5.
- Individual participant dataSharing planned: Yes. The detailed protocol describing the techniques used in the study and the anesthetic conduct and the outcome measures. The statistical plan to analyze the different outcome measures.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Mohamed Abd El Fattah, Associate professor principal investigator
National Cancer Institute, Egypt
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Ultrasound guided Rectus sheath block and ultrasound guided external oblique intercostal plane block in people with Post Operative Analgesia, run by Kasr El Aini Hospital at 2 sites in Egypt.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 2 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Time to first request for rescue analgesia (time frame: Time in hours from end of surgery to first dose of morphine administered up to 24 hours postoperatively). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07055438, which also lists 5 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Dec 2025.