Post Operative PainNCT07094386
Postoperative Analgesia in Patients Undergoing Open Upper Abdominal Surgeries: External Oblique Intercostal Plane Block vs. Quadratus Lumborum Block
A study testing External Oblique Intercostal Plain Block, Quadratus Lumborum Block and Bupivacaine %0.25 (isobaric) in people with Post Operative Pain, run by Cairo University at 1 site in Egypt.
Trial summary
Open upper abdominal surgeries with subcostal incisions are a cause of severe pain and can lead to pulmonary and cardiac complications, detrimental physiological effects, and may also have psychological, economic, and social adverse effects if inadequately treated. Read more about this study
- Who is it for?
- Ages 18 to 60 years
- Conditions the study is for
- Post Operative Pain
- What is being tested?
- External Oblique Intercostal Plain Block, Quadratus Lumborum Block and Bupivacaine %0.25 (isobaric)
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 80 participants
- Where
- 1 siteEgypt
- Study dates
- 15 Aug 2025to 15 Apr 2026
- 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 60 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Patients from both sexes.
- 18 to 60 years old.
- ASA physical status I- III scheduled for elective open upper abdominal surgeries, as (open nephrectomy, open cholecystectomy, liver resection, ….).
- Patients with BMI (18.5-35) kg/ m2.
Who cannot join
- Patients uncooperative or refuse to sign the consent of regional block.
- Patients with known coagulation defects. International normalized ratio (INR)> 1.5), and thrombocytopenia if platelet count < 100.000).
- Patients with known hypersensitivity to bupivacaine, or any of the used drugs.
- Patients with hepatic impairment, as Child-Pugh class B or C, AST/ALT > 3 times the upper limit of normal, or total bilirubin > 2 mg/dL.
- Patients with renal impairment, chronic kidney disease stage 4 or 5 (eGFR < 30 mL/min/1.73 m²), or on regular dialysis.
- Patients with pre-existing myopathy, defined as a clinically diagnosed muscular disorder characterized by muscle weakness, elevated creatine kinase levels, or a history of inherited or acquired muscle disease (e.g., polymyositis, muscular dystrophy).
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- Patients with pre-existing neuropathy, if clinically diagnosed as peripheral or central nerve dysfunction, including chronic sensorimotor deficits or conditions such as diabetic neuropathy, radiculopathy, or multiple sclerosis.
- Patients with chronic pain syndromes, defined as pain persisting for more than 3 months, including fibromyalgia, complex regional pain syndrome (CRPS), or chronic pain requiring long-term opioid or neuropathic pain medications.
- Patients with sepsis at the site of injection.
- Patients with history of long-acting opioids or steroids preoperatively
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Ultrasound Guided Techniques for Postoperative Analgesia in Patients Undergoing Open Upper Abdominal Surgeries: External Oblique Intercostal Plane Block vs. Quadratus Lumborum Block; A Randomized Controlled Trial
Open upper abdominal surgeries with subcostal incisions are a cause of severe pain and can lead to pulmonary and cardiac complications, detrimental physiological effects, and may also have psychological, economic, and social adverse effects if inadequately treated. Effective pain control can avoid these complications and contribute to several clinically valuable outcomes, including earlier patient mobilization and quicker recovery, which can result in a shortened hospital stay and reduced costs.
Opioids are the gold standard in postoperative pain control. however, it increases the incidence of opioid related adverse events such as respiratory depression, dizziness, nausea, vomiting and constipation. Regional analgesia plays an important role in perioperative multimodal analgesic regimens for major abdominal surgeries. The ultrasound-guided technique provides several options for relieving postoperative pain.
The aim of this study is to compare the efficacy and safety of ultrasound guided external oblique intercostal plane block versus quadratus lumborum in patients undergoing open upper abdominal surgeries.
Read the detailed description
Poorly controlled postoperative pain causes physiological stress, increased morbidity, delayed mobilization, prolonged hospitalization, and higher healthcare costs.
Regional anelgesia techniques have shown a promise in improving postoperative outcomes by reducing opioid consumption and related adverse effects.
This study aims to evaluate two regional blocks - EOIPB and QLB- both will be performed under ultrasound guidance.
The goal is to determine which technique offers superior analgesic efficacy, safety and overall contribution to the quality of recovery.
- Conditions
- Post Operative Pain
- Being tested
- External Oblique Intercostal Plain Block, Quadratus Lumborum Block, Bupivacaine %0.25 (isobaric)
- Medical subject headings
- Pain, Postoperative
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
External Oblique Intercostal Plain BlockProcedure or surgery
The patient will be placed in the supine position. After sterilization of the skin, a high-frequency linear probe (6-13 MHz) will be placed obliquely medial to the anterior axillary line, the 6th and 7th ribs, skin, subcutaneous tissues, and external oblique muscle [EOM], intercostal muscles, pleura, and the lung will be identified. An 80 mm 22-gauge block needle (Stimuplex® D, BBraun, Germany) will be inserted in-plane to the US-probe in a craniocaudal direction directed under EOM. After confirmation of negative blood aspiration, 2-3 mL of normal saline will be injected for hydro-dissection to verify the correct needle tip placement then 30 mL of 0.25% bupivacaine will be injected between the EOM and intercostal muscles
Quadratus Lumborum BlockProcedure or surgery
Quadratus lumborum block will be performed. The patient will be placed in the lateral decubitus position After sterilization of the skin, a low frequency convex probe (5-8 MHz) will be positioned horizontally in the anterior axillary line half way between the subcostal margin and the iliac crest then will be advanced in the cranial direction to visualize the triple abdominal muscle layers and identifying the posterior border of the EO muscle (hook sign) with the underlying IO musclenforming a roof over the QL muscle. The QL muscle could be visualized with its attachment to the lateral edge of the transverse process of the L4 vertebral body. An 80 mm 22-gauge block needle will be inserted in-plane to the US-probe in an anterolateral to posteromedial direction. The needle tip will be placed between the middle layer of the thoracolumbar fascia and the QL muscle. After confirmation of negative blood aspiration, 30 mL of 0.25% bupivacaine will be injected.
Bupivacaine %0.25 (isobaric)Drug
A single injection of 30 mg of 0.25 % bupivacaine will be administered as part of the External Oblique Intercostal Plain Block under ultrasound guidance, after confirming needle placement between the external oblique and intercostal muscles.
Bupivacaine %0.25 (isobaric)Drug
A single injection of 30 mg of 0.25 % bupivacaine will be administered as part of the Quadratus Lumborum Block under ultrasound guidance, after confirming of correct needle placement and negative aspiration.
| Study group | Role | What they receive |
|---|---|---|
| Group External Oblique Intercostal Plain Block (EOIPB) | Active comparator | Patients will receive general anesthesia initially then unilateral EOIPB with total volume 30 ml of bupivacaine 0.25% will be performed. Receives: Procedure: External Oblique Intercostal Plain Block; Drug: Bupivacaine %0.25 (isobaric) |
| Group Quadratus Lumborum Block (QLB) | Active comparator | Patients will receive general anesthesia initially then unilateral QLB with total volume 30 ml of bupivacaine 0.25% will be performed. Receives: Procedure: Quadratus Lumborum Block; Drug: Bupivacaine %0.25 (isobaric) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Time to first requested rescue analgesia (minutes)
Measured: 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 posted30 Jul 2025
- Study start15 Aug 2025
- Primary completion15 Apr 2026
- Study completion15 Apr 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Post Operative PainStudies of the same condition, open and under way.
- More trials run by Cairo UniversityThe sponsor's other registered studies.
- 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, Care provider
- Enrolment
- 80 participants (actual)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Ahmed Shaaban Glall Ismail, Cairo University
- Investigators
- Nesrine Elrefai, Professor, Study director, Cairo university, Faulty of MdicineAhmed El Sakka, Professor, Study chair, Cairo university, Faulty of Mdicine
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07094386
- Sponsor's protocol ID
- MD-135-2025
- Status last verified
- Jul 2025
- First submitted
- 16 Jul 2025
- Last updated
- 6 Oct 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 6 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Ultrasound Guided Techniques for Postoperative Analgesia in Patients Undergoing Open Upper Abdominal Surgeries: External Oblique Intercostal Plane Block vs. Quadratus Lumborum Block; A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07094386
- Acronym / sponsor ID
- MD-135-2025
- Conditions
- Post Operative Pain
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 80 participants (actual)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- 15 Aug 2025 (actual)
- Primary completion
- 15 Apr 2026 (actual)
- Study completion
- 15 Apr 2026 (actual)
- First posted
- 30 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.
Open upper abdominal surgeries with subcostal incisions are a cause of severe pain and can lead to pulmonary and cardiac complications, detrimental physiological effects, and may also have psychological, economic, and social adverse effects if inadequately treated. Effective pain control can avoid these complications and contribute to several clinically valuable outcomes, including earlier patient mobilization and quicker recovery, which can result in a shortened hospital stay and reduced costs.
Opioids are the gold standard in postoperative pain control. however, it increases the incidence of opioid related adverse events such as respiratory depression, dizziness, nausea, vomiting and constipation. Regional analgesia plays an important role in perioperative multimodal analgesic regimens for major abdominal surgeries. The ultrasound-guided technique provides several options for relieving postoperative pain.
The aim of this study is to compare the efficacy and safety of ultrasound guided external oblique intercostal plane block versus quadratus lumborum in patients undergoing open upper abdominal surgeries.
Detailed description
Poorly controlled postoperative pain causes physiological stress, increased morbidity, delayed mobilization, prolonged hospitalization, and higher healthcare costs.
Regional anelgesia techniques have shown a promise in improving postoperative outcomes by reducing opioid consumption and related adverse effects.
This study aims to evaluate two regional blocks - EOIPB and QLB- both will be performed under ultrasound guidance.
The goal is to determine which technique offers superior analgesic efficacy, safety and overall contribution to the quality of recovery.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, care provider)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Group External Oblique Intercostal Plain Block (EOIPB) | Active comparator | Procedure: External Oblique Intercostal Plain Block, Drug: Bupivacaine %0.25 (isobaric)Patients will receive general anesthesia initially then unilateral EOIPB with total volume 30 ml of bupivacaine 0.25% will be performed. |
| Group Quadratus Lumborum Block (QLB) | Active comparator | Procedure: Quadratus Lumborum Block, Drug: Bupivacaine %0.25 (isobaric)Patients will receive general anesthesia initially then unilateral QLB with total volume 30 ml of bupivacaine 0.25% will be performed. |
Who may qualify
- Ages
- 18 to 60 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (4 listed)
- Patients from both sexes.
- 18 to 60 years old.
- ASA physical status I- III scheduled for elective open upper abdominal surgeries, as (open nephrectomy, open cholecystectomy, liver resection, ….).
- Patients with BMI (18.5-35) kg/ m2.
Key exclusion criteria (10 listed)
- Patients uncooperative or refuse to sign the consent of regional block.
- Patients with known coagulation defects. International normalized ratio (INR)> 1.5), and thrombocytopenia if platelet count < 100.000).
- Patients with known hypersensitivity to bupivacaine, or any of the used drugs.
- Patients with hepatic impairment, as Child-Pugh class B or C, AST/ALT > 3 times the upper limit of normal, or total bilirubin > 2 mg/dL.
- Patients with renal impairment, chronic kidney disease stage 4 or 5 (eGFR < 30 mL/min/1.73 m²), or on regular dialysis.
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 |
|---|---|---|
| External Oblique Intercostal Plain BlockThe patient will be placed in the supine position. After sterilization of the skin, a high-frequency linear probe (6-13 MHz) will be placed obliquely medial to the anterior axillary line, the 6th and 7th ribs, skin, subcutaneous tissues, and external oblique muscle [EOM], intercostal muscles, pleura, and the lung will be identified. An 80 mm 22-gauge block needle (Stimuplex® D, BBraun, Germany) will be inserted in-plane to the US-probe in a craniocaudal direction directed under EOM. After confirmation of negative blood aspiration, 2-3 mL of normal saline will be injected for hydro-dissection to verify the correct needle tip placement then 30 mL of 0.25% bupivacaine will be injected between the EOM and intercostal muscles | Procedure or surgery | Group External Oblique Intercostal Plain Block (EOIPB) |
| Quadratus Lumborum BlockQuadratus lumborum block will be performed. The patient will be placed in the lateral decubitus position After sterilization of the skin, a low frequency convex probe (5-8 MHz) will be positioned horizontally in the anterior axillary line half way between the subcostal margin and the iliac crest then will be advanced in the cranial direction to visualize the triple abdominal muscle layers and identifying the posterior border of the EO muscle (hook sign) with the underlying IO musclenforming a roof over the QL muscle. The QL muscle could be visualized with its attachment to the lateral edge of the transverse process of the L4 vertebral body. An 80 mm 22-gauge block needle will be inserted in-plane to the US-probe in an anterolateral to posteromedial direction. The needle tip will be placed between the middle layer of the thoracolumbar fascia and the QL muscle. After confirmation of negative blood aspiration, 30 mL of 0.25% bupivacaine will be injected. | Procedure or surgery | Group Quadratus Lumborum Block (QLB) |
| Bupivacaine %0.25 (isobaric)A single injection of 30 mg of 0.25 % bupivacaine will be administered as part of the External Oblique Intercostal Plain Block under ultrasound guidance, after confirming needle placement between the external oblique and intercostal muscles. | Drug | Group External Oblique Intercostal Plain Block (EOIPB) |
| Bupivacaine %0.25 (isobaric)A single injection of 30 mg of 0.25 % bupivacaine will be administered as part of the Quadratus Lumborum Block under ultrasound guidance, after confirming of correct needle placement and negative aspiration. | Drug | Group Quadratus Lumborum Block (QLB) |
Primary outcome
Time to first requested rescue analgesia (minutes)
Time frame: 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 6 Oct 2026.
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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.
Nesrine Elrefai, Professor study director
Cairo university, Faulty of Mdicine
Ahmed El Sakka, Professor study chair
Cairo university, Faulty of Mdicine
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing External Oblique Intercostal Plain Block, Quadratus Lumborum Block and Bupivacaine %0.25 (isobaric) in people with Post Operative Pain, run by Cairo University at 1 site 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 6 Oct 2026. 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 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 requested rescue analgesia (minutes) (time frame: 24 hours postoperatively). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 6 Oct 2026; AzTrials last refreshed its copy on 6 Nov 2026.