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Hernia, UmbilicalPhase 2/3NCT07062497

Clonidine in Ultrasound-guided Rectus Sheath Block for Outpatient Umbilical Hernioplasty

A Phase 2/3 study testing Rectus Sheath Block and Rectus Sheath Block with Clonidine in people with Hernia, Umbilical and Clonidine, run by Universidade Federal do Rio de Janeiro at 1 site in Brazil.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This clinical trial aims to evaluate the effectiveness of an ultrasound-guided nerve block technique as the sole anesthetic method for patients undergoing outpatient umbilical hernia surgery. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Hernia, Umbilical, Clonidine, Pain, Postoperative
What is being tested?
Rectus Sheath Block and Rectus Sheath Block with Clonidine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
62 participants
Where
1 siteBrazil
Study dates
7 Jan 2025to 30 Apr 2026
Phase
Phase 2/3
Are there results?
Not yet: the study is under way

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

  • Adults aged 18 to 65 years;
  • Both male and female participants;
  • ASA physical status I or II (American Society of Anesthesiologists classification);
  • Scheduled for elective ambulatory umbilical hernia repair;
  • Hernial defect size ≤ 4 cm (small to medium).

Who cannot join

  • Refusal or inability to provide written informed consent;
  • Cognitive or psychiatric disorders that impair comprehension or adherence to the study protocol;
  • Known allergy or hypersensitivity to local anesthetics, clonidine, opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), or other analgesics;
  • Participation in another clinical trial within the previous 30 days;
  • Missing data or loss to follow-up during postoperative assessments;
  • Contraindications to regional anesthesia or known coagulopathy.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Samuel N Abreu, MD contact

55 21 987901911

samuel.abreu@ppc.uerj.br

Brazil1 site, 1 recruiting
  • Policlinica Universitária Piquet Carneiro

    Rio de Janeiro, Rio de Janeiro, 20950-003

    Samuel N Abreu, MD, +55 21 2566-7000, contato.ppc@uerj.br

    Recruiting

Other trials in Brazil

About this study

Official title: Ultrasound-guided Rectus Abdominis Muscle Sheath Block in Outpatient Umbilical Hernioplasties: a Comparative Analysis of the Use of Clonidine as an Adjuvant - Prospective Randomized Clinical Trial

This clinical trial aims to evaluate the effectiveness of an ultrasound-guided nerve block technique as the sole anesthetic method for patients undergoing outpatient umbilical hernia surgery. The procedure, called rectus sheath block (RSB), involves injecting local anesthetic near the abdominal muscles to reduce pain during and after surgery. The study will compare two groups of adult patients: one receiving the nerve block with a medication called clonidine added to the anesthetic solution, and the other receiving the same block without clonidine. Clonidine may help improve pain control and reduce the need for additional pain medications. By analyzing pain scores, recovery quality, and potential side effects, the study seeks to determine whether the use of clonidine in this context is safe, cost-effective, and beneficial for patient recovery. Participants will answer questionnaires about their pain and recovery during the first 48 hours after surgery.

Read the detailed description

This is a prospective, randomized, double-blind, controlled clinical trial designed to evaluate the effectiveness and safety of adding clonidine to a local anesthetic solution for ultrasound-guided rectus sheath block (RSB) in adult patients undergoing ambulatory umbilical hernioplasty. The study will be conducted at the Ambulatory Surgery Unit of the Policlínica Universitária Piquet Carneiro, part of the Universidade do Estado do Rio de Janeiro (UERJ), between January 2025 and April 2026.

Eligible patients (ASA I or II, aged 18-65) scheduled for elective outpatient umbilical hernia repair with a hernial defect ≤ 4 cm will be randomized into two groups. The intervention group (BRA-CLO) will receive bilateral RSB with a solution containing 8 mL of lidocaine 2%, 8 mL of ropivacaine 1%, and clonidine 75 mcg, diluted in 0.9% saline to a total volume of 20 mL, administered on each side. The control group (BRA) will receive an identical volume and concentration of local anesthetic without the addition of clonidine.

RSB will be performed under real-time ultrasound guidance (Butterfly iQ+ probe) using an in-plane technique with a Quincke 22G needle. Sedation with midazolam, fentanyl, and propofol will be administered as required. The block will be performed preoperatively under standard monitoring, including ECG, pulse oximetry, and non-invasive blood pressure.

The primary hypothesis is that the addition of clonidine will enhance the quality of intraoperative and postoperative analgesia, reduce opioid consumption, and improve overall postoperative recovery without increasing the risk of adverse events. To assess recovery quality, the validated Quality of Recovery-15 (QoR-15) questionnaire will be administered at postoperative 24 and 48 hours. Pain will be assessed using the Numeric Rating Scale (NRS) at predefined intervals (PACU, 24h and 48h). Sedation will be measured with the Richmond Agitation-Sedation Scale (RASS), and adverse events such as bradycardia, nausea, vomiting, conversion to general anesthesia, and postoperative complications will be recorded.

Randomization will be performed using block randomization with variable block sizes (4, 6, or 8) generated in R (v4.4.1), and allocation concealment will be ensured with sealed opaque envelopes. Data will be collected and managed using the REDCap platform, ensuring confidentiality and integrity.

The study aims to fill an important gap in evidence regarding the use of alpha-2 adrenergic agonists as adjuvants in abdominal wall blocks, especially in the context of ambulatory surgery. It is expected that the findings will support the safe and effective use of clonidine to optimize regional anesthesia protocols in hernia repair.

Being tested
Rectus Sheath Block, Rectus Sheath Block with Clonidine
Keywords
Rectus Sheath Block, Ultrasound-Guided Regional Anesthesia, Umbilical Hernia Repair, Clonidine, Local Anesthetics, Postoperative Pain Management, Ambulatory Surgery, Quality of Recovery, Alpha-2 Adrenergic Agonists, Pain Measurement, Analgesic Adjuvants
Medical subject headings
Hernia, Umbilical, Pain, Postoperative

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Rectus Sheath BlockDrug

    Also called RSB

    Participants in this arm will receive bilateral ultrasound-guided rectus sheath block (RSB) with a solution containing 8 mL of lidocaine 2% + 8 mL of ropivacaine 1%, diluted in 0.9% saline to a total volume of 20 mL, each side, without the addition of clonidine.

  • Rectus Sheath Block with ClonidineDrug

    Also called RSB with clonidine

    Participants in this arm will receive bilateral ultrasound-guided rectus sheath block (RSB) with a solution containing 8 mL of lidocaine 2% + 8 mL of ropivacaine 1% + clonidine 75 mcg, diluted in 0.9% saline to a total volume of 20 mL, each side, without the addition of clonidine.

Study groups in NCT07062497
Study groupRoleWhat they receive
Rectus Sheath BlockActive comparatorParticipants in this arm will receive bilateral ultrasound-guided rectus sheath block (RSB) without the addition of clonidine.
Receives: Drug: Rectus Sheath Block
Rectus sheath block with clonidineActive comparatorParticipants in this arm will receive bilateral ultrasound-guided rectus sheath block (RSB) with clonidine
Receives: Drug: Rectus Sheath Block with Clonidine

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Total opioid postoperative consumption

    Total amount of opioid analgesics (in milligrams of tramadol equivalents) administered from the end of the surgical procedure to 48 hours postoperatively.

    Measured: 48 hours postoperative

  2. Postoperative pain intensity assessed by Numeric Rating Scale (NRS)

    Pain scores reported by the patient using the 11-point Numeric Rating Scale (0 = no pain; 10 = worst imaginable pain) at each time point.

    Measured: At post-anesthesia care unit (PACU) admission (immediately after surgery), 24 hours after surgery, and 48 hours after surgery.

  3. Total intraoperative opioid consumption

    Total intraoperative fentanyl consumption

    Measured: From induction of anesthesia to the end of surgery.

Secondary outcomes (2)
  1. Quality of recovery assessed by QoR-15 questionnaire

    Patient-reported recovery quality measured using the Quality of Recovery-15 (QoR-15) instrument, scored from 0 to 150, with higher scores indicating better recovery.

    Measured: At post-anesthesia care unit (PACU) admission (immediately after surgery), 24 hours after surgery, and 48 hours after surgery.

  2. Incidence of postoperative nausea and vomiting (PONV)

    Number of patients who experience at least one episode of nausea and/or vomiting in the first 48 hours after surgery.

    Measured: 48 hours postoperatively

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 Jul 2025
  2. Study start7 Jan 2025
  3. Primary completion16 Dec 2025 (estimated)
  4. Study completion30 Apr 2026 (estimated)

Resources

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 2/3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
This is a parallel-assignment, randomized, double-blind, controlled clinical trial involving two intervention arms. Eligible adult patients undergoing ambulatory umbilical hernia repair are allocated in a 1:1 ratio to receive either ultrasound-guided rectus sheath block (RSB) with local anesthetics alone (control group) or RSB with local anesthetics plus clonidine (intervention group). Randomization is performed using block randomization with variable block sizes to ensure balance between groups. Allocation is concealed through sealed opaque envelopes. Both participants and outcome assessors are blinded to group assignment.
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
62 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07062497
Sponsor's protocol ID
83635224.9.0000.5259
Other IDs
111111111111
Status last verified
Dec 2024
First submitted
24 Jun 2025
Last updated
14 Jul 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Individual participant data (IPD) will be made available upon reasonable request to the corresponding author, following appropriate de-identification procedures and in accordance with local ethical guidelines.

Publications

  • Xuan C, Yan W, Wang D, Li C, Ma H, Mueller A, Wang J. The Facilitatory Effects of Adjuvant Pharmaceutics to Prolong the Duration of Local Anesthetic for Peripheral Nerve Block: A Systematic Review and Network Meta-analysis. Anesth Analg. 2021 Sep 1;133(3):620-629. doi: 10.1213/ANE.0000000000005640.

    PubMed 34153021
  • Visoiu M, Scholz S, Malek MM, Carullo PC. The addition of clonidine to ropivacaine in rectus sheath nerve blocks for pediatric patients undergoing laparoscopic appendectomy: A double blinded randomized prospective study. J Clin Anesth. 2021 Aug;71:110254. doi: 10.1016/j.jclinane.2021.110254. Epub 2021 Mar 19.

    PubMed 33752119
  • Kwon HJ, Kim YJ, Kim Y, Kim S, Cho H, Lee JH, Kim DH, Jeong SM. Complications and Technical Consideration of Ultrasound-Guided Rectus Sheath Blocks: A Retrospective Analysis of 4033 Patients. Anesth Analg. 2023 Feb 1;136(2):365-372. doi: 10.1213/ANE.0000000000006282. Epub 2022 Nov 29.

    PubMed 36638514
  • Cucchiaro G, Ganesh A. The effects of clonidine on postoperative analgesia after peripheral nerve blockade in children. Anesth Analg. 2007 Mar;104(3):532-7. doi: 10.1213/01.ane.0000253548.97479.b8.

    PubMed 17312203

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing Rectus Sheath Block and Rectus Sheath Block with Clonidine in people with Hernia, Umbilical and Clonidine, run by Universidade Federal do Rio de Janeiro at 1 site in Brazil.

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 5 inclusion and 6 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: looking for participants now, as of the sponsor's last update on 14 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Brazil. 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.

What does this combined phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Samuel N Abreu, MD (55 21 987901911, samuel.abreu@ppc.uerj.br), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Total opioid postoperative consumption (time frame: 48 hours postoperative). The study lists 3 primary outcomes in all. 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 NCT07062497, which also lists 4 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 14 Jul 2025.

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