Liver ResectionNCT07740382
Comparative Effects of ESP Block and EOIP Block on Postoperative Respiratory Recovery Following Liver Resection
A study testing Ultrasound-guided bilateral external oblique intercostal plane (EOIP) block and Ultrasound-guided bilateral erector spinae plane (ESP) block in people with Liver Resection and Upper Abdominal Surgeries, run by Menoufia University at 1 site in Egypt.
Trial summary
This study evaluates respiratory recovery as a multidimensional construct using clinically relevant and measurable parameters, including LUS, diaphragmatic excursion, oxygen requirement, and PPCs. Read more about this study
- Who is it for?
- Ages 18 to 75 years
- Conditions the study is for
- Liver Resection, Upper Abdominal Surgeries
- What is being tested?
- Ultrasound-guided bilateral external oblique intercostal plane (EOIP) block and Ultrasound-guided bilateral erector spinae plane (ESP) block
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 116 participants
- Where
- 1 siteEgypt
- Study dates
- Sep 2026to 1 Jan 2027
- Phase
- Interventional
- 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 75 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- 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.
Who cannot join
- 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
Show all 14Show fewer
- 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.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Egypt1 site, 1 recruiting
- Recruiting
National Liver Institute, Menoufia University
Alexandria, Sbein-Elkom, 32511
Nevine Mostafa Soliman, 01128861471, mostafanevine@gmail.com
About this study
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
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.
- Conditions
- Liver Resection, Upper Abdominal Surgeries
- Being tested
- Ultrasound-guided bilateral external oblique intercostal plane (EOIP) block, Ultrasound-guided bilateral erector spinae plane (ESP) block
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Ultrasound-guided bilateral external oblique intercostal plane (EOIP) blockProcedure or surgery
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 correct plane.
Bilateral EOIP block
- after induction of general anesthesia and before surgical incision.
- ultrasound-guided injection into the fascial plane between the external oblique muscle and the intercostal muscle/external intercostal membrane near the 6th-8th intercostal spaces on each side, following the institutional standardized approach.
- Injectate: 20 mL of 0.25% bupivacaine per side Safter negative aspiration.
Ultrasound-guided bilateral erector spinae plane (ESP) blockProcedure or surgery
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 hydrodissection.
| Study group | Role | What they receive |
|---|---|---|
| The external oblique intercostal plane (EOIP) block | Active comparator | newer fascial plane block that targets the thoracoabdominal nerves within the fascial plane between the external oblique and intercostal muscles. Its dermatomal coverage, typically spanning T6 to T10-T11, corresponds well with common upper abdominal surgical incisions. Emerging randomized data indicate that EOIP block provides effective postoperative analgesia and may be faster and technically easier to perform than deeper blocks. In open liver surgery, where subcostal and J-shaped incisions are frequently used, the EOIP block appears anatomically well-matched to the surgical field . Receives: Procedure: Ultrasound-guided bilateral external oblique intercostal plane (EOIP) block |
| The erector spinae plane (ESP) block | Active comparator | gained widespread use due to its relative technical simplicity, safety profile, and potential to provide both somatic and visceral analgesia. Meta-analytic evidence suggests that ESP block reduces postoperative opioid consumption and pain scores in abdominal surgery compared with control or alternative techniques. Receives: Procedure: Ultrasound-guided bilateral erector spinae plane (ESP) block |
What is being measured
The primary outcome is the main question the study is designed to answer.
Right diaphragmatic excursion
Right diaphragmatic excursion will be measured during quiet tidal breathing in the semi-recumbent position using M-mode ultrasonography through a right subcostal hepatic acoustic window. Three consecutive respiratory cycles will be recorded and averaged at each assessment measured in cm.
Measured: Baseline, and 1, 6, and 24 hours after surgery.
Secondary outcomes (5)
Mean postoperative pain intensity at rest, during coughing or deep breathing
Postoperative pain intensity at rest will be assessed using the Numeric Rating Scale NRS score 0-10.
Postoperative pain intensity during coughing or deep breathing will be assessed using the Numeric Rating Scale NRS score 0-10.
Measured: 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
Total cumulative opioid consumption during the first 24 postoperative hours. Measured in Morphine milligram equivalents (MME). Total opioid administered during the intraoperative period from induction of anesthesia until completion of surgery.
Measured in Morphine milligram equivalents (MME).
Measured: First 24 postoperative hours.
Number of participants requiring supplemental oxygen
Number of participants requiring supplemental oxygen or escalation of oxygen therapy beyond standard postoperative care to maintain peripheral oxygen saturation (SpO₂) ≥94%, according to institutional postoperative care protocols.
Number of participants (%)
Measured: First 24 postoperative hours.
Number of participants with early postoperative pulmonary complications
Number of participants who develop early postoperative pulmonary complications within 7 days after surgery, including clinically significant atelectasis.
Number of participants (%)
Measured: Within 7 postoperative days.
Mean lung ultrasound score
Lung ultrasound score will be assessed using a standardized 12-zone protocol lung ultrasound score 0-36.
Measured: During the first 24 postoperative hours at predefined assessment time points.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted31 Jul 2026
- Study startSep 2026 (estimated)
- Primary completion1 Jan 2027 (estimated)
- Study completion1 Jan 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Liver ResectionStudies 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
- Diagnosis
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 116 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Menoufia University
- Sponsor type
- University, hospital or other
- Collaborators
- National Liver Institute, Egypt
- Responsible party
- Principal investigator, Nevine Mostafa Soliman, Menoufia University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07740382
- Sponsor's protocol ID
- NLI IRB 00014014/ FWA00034015
- Status last verified
- Jul 2026
- First submitted
- 18 Jul 2026
- Last updated
- 6 Oct 2026
- Results posted
- No
- Data monitoring committee
- No
- 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
- Comparative Effects of Erector Spinae Plane Block and External Oblique Intercostal Plane Block on Postoperative Respiratory Recovery Following Liver Resection: A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07740382
- Acronym / sponsor ID
- NLI IRB 00014014/ FWA00034015
- Conditions
- Liver Resection, Upper Abdominal Surgeries
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 116 participants (estimated)
- Lead sponsor
- Menoufia UniversityUniversity, hospital or other
- Collaborators
- National Liver Institute, Egypt
- Study start
- Sep 2026 (estimated)
- Primary completion
- 1 Jan 2027 (estimated)
- Study completion
- 1 Jan 2027 (estimated)
- First posted
- 31 Jul 2026 (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.
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.
Study design
- Primary purpose
- Diagnosis
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| The external oblique intercostal plane (EOIP) block | Active comparator | Procedure: Ultrasound-guided bilateral external oblique intercostal plane (EOIP) blocknewer fascial plane block that targets the thoracoabdominal nerves within the fascial plane between the external oblique and intercostal muscles. Its dermatomal coverage, typically spanning T6 to T10-T11, corresponds well with common upper abdominal surgical incisions. Emerging randomized data indicate that EOIP block provides effective postoperative analgesia and may be faster and technically easier to perform than deeper blocks. In open liver surgery, where subcostal and J-shaped incisions are frequently used, the EOIP block appears anatomically well-matched to the surgical field . |
| The erector spinae plane (ESP) block | Active comparator | Procedure: Ultrasound-guided bilateral erector spinae plane (ESP) blockgained widespread use due to its relative technical simplicity, safety profile, and potential to provide both somatic and visceral analgesia. Meta-analytic evidence suggests that ESP block reduces postoperative opioid consumption and pain scores in abdominal surgery compared with control or alternative techniques. |
Who may qualify
- Ages
- 18 to 75 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- 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.
Key exclusion criteria (14 listed)
- 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
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 bilateral external oblique intercostal plane (EOIP) blockBilateral 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 correct plane. Bilateral EOIP block * after induction of general anesthesia and before surgical incision. * ultrasound-guided injection into the fascial plane between the external oblique muscle and the intercostal muscle/external intercostal membrane near the 6th-8th intercostal spaces on each side, following the institutional standardized approach. * Injectate: 20 mL of 0.25% bupivacaine per side Safter negative aspiration. | Procedure or surgery | The external oblique intercostal plane (EOIP) block |
| Ultrasound-guided bilateral erector spinae plane (ESP) blockAn 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 hydrodissection. | Procedure or surgery | The erector spinae plane (ESP) block |
Primary outcome
Right diaphragmatic excursion
Time frame: Baseline, and 1, 6, and 24 hours after surgery.
Right diaphragmatic excursion will be measured during quiet tidal breathing in the semi-recumbent position using M-mode ultrasonography through a right subcostal hepatic acoustic window. Three consecutive respiratory cycles will be recorded and averaged at each assessment measured in cm.
5 secondary outcomes
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.
Results and safety
This study is still under way. Results are not available in the source record yet.
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.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Ultrasound-guided bilateral external oblique intercostal plane (EOIP) block and Ultrasound-guided bilateral erector spinae plane (ESP) block in people with Liver Resection and Upper Abdominal Surgeries, run by Menoufia 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 14 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 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?
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 Nevine Mostafa Soliman (01128861471, nevinemostafa@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Right diaphragmatic excursion (time frame: Baseline, and 1, 6, and 24 hours after surgery.). 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.