Postoperative PainNCT07787221
QL Block Versus EO Plane Block for Analgesia After Open Nephrectomy
A study testing Quadratus Lumborum Block (QLB) and External Oblique Plane Block in people with Postoperative Pain, run by Cairo University at 2 sites in Egypt.
Trial summary
This prospective randomized clinical trial aims to compare two ultrasound-guided regional anesthesia techniques, the transmuscular quadratus lumborum (QL) block and the external oblique (EO) plane block, for pain relief after open nephrectomy. Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Postoperative Pain
- What is being tested?
- Quadratus Lumborum Block (QLB) and External Oblique Plane Block
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 54 participants
- Where
- 2 sitesEgypt
- Study dates
- 1 Apr 2026to 1 May 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 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Adult patients aged 18 to 65 years.
- Patients undergoing open nephrectomy at the National Cancer Institute, Cairo University.
- American Society of Anesthesiologists (ASA) physical status II-III.
- Body mass index (BMI) greater than 20 kg/m² and less than 35 kg/m².
Who cannot join
- Patient refusal to participate.
- ASA physical status IV.
- Age less than 18 years or greater than 65 years.
- BMI less than 20 kg/m² or greater than 35 kg/m².
- Known allergy or contraindication to any study medication, including local anesthetics or opioids.
- History of psychiatric disorders or chronic pain.
- Contraindications to regional anesthesia, including local infection at the injection site, pre-existing neuropathy, or coagulopathy.
- Severe organ dysfunction, including cardiac dysfunction (ejection fraction <40%), respiratory dysfunction (FEV1 <50% of predicted or requirement for home oxygen therapy), hepatic dysfunction (Child-Pugh class C), or renal dysfunction (estimated glomerular filtration rate <30 mL/min/1.73 m²).
Trial locations and contacts
2 sites in 1 country. Contact the study team or a site near you to ask about taking part.
Egypt2 sites, 2 recruiting
- Recruiting
Cairo University
Cairo, 11796
sayed M Abed, MD, 002-01226806532, sayed.abed@nci.cu.edu.eg
Nourhan R Ali Hassan, Master's, 002-01200858194, nourhanrabeaali@gmail.com
- Recruiting
Cairo University
Cairo
sayed M Abed, MD, 002-01226806532, sayed.abed@nci.cu.edu.eg
Nourhan R Ali Hassan, Master's, 002-01200858194, nourhanrabeaali@gmail.com
About this study
Official title: Quadratus Lumborum Block Versus External Oblique Plane Block for Analgesia After Open Nephrectomy: A Prospective Randomized Clinical Trial
This prospective randomized clinical trial aims to compare two ultrasound-guided regional anesthesia techniques, the transmuscular quadratus lumborum (QL) block and the external oblique (EO) plane block, for pain relief after open nephrectomy. Open nephrectomy is a major surgical procedure that can cause significant postoperative pain and may require opioid medications for adequate pain control.
Adult patients undergoing open nephrectomy at the National Cancer Institute, Cairo University, who meet the study eligibility criteria will be randomly assigned to receive either a QL block or an EO plane block before surgery. Both techniques will be performed under ultrasound guidance using bupivacaine in addition to standardized general anesthesia and multimodal postoperative analgesia.
Read more
The main purpose of the study is to determine whether the QL block provides better postoperative analgesia than the EO plane block. The primary outcome will be the total amount of intravenous morphine consumed during the first 24 hours after surgery. Secondary outcomes will include postoperative pain scores, time to first request for rescue analgesia, hemodynamic changes, recovery time, patient satisfaction, and adverse effects related to analgesia or the regional anesthesia techniques.
A total of 54 patients will be enrolled and randomly allocated equally between the two treatment groups.
Read the detailed description
The study is a prospective, randomized clinical trial designed to compare the analgesic efficacy of the transmuscular quadratus lumborum block with the external oblique plane block in adult patients undergoing open nephrectomy.
Open nephrectomy is associated with substantial postoperative pain because of the extent of the surgical incision, muscular dissection, and manipulation of retroperitoneal structures. Effective postoperative analgesia is important to facilitate recovery, mobilization, respiratory function, and patient comfort while minimizing opioid requirements.
The quadratus lumborum block is a posterior abdominal wall fascial plane block in which local anesthetic is deposited in relation to the quadratus lumborum muscle. The technique may provide analgesia over several thoracoabdominal dermatomes and may have both somatic and visceral analgesic effects. The external oblique plane block is a more superficial fascial plane technique that targets the lateral abdominal wall and may provide effective somatic analgesia.
Eligible patients will be randomly allocated in a 1:1 ratio to receive either a transmuscular QL block or an EO plane block before induction of general anesthesia. All patients will receive standardized general anesthesia and multimodal postoperative analgesia. The regional blocks will be performed under ultrasound guidance by an experienced anesthesiologist.
The primary outcome is total intravenous morphine consumption during the first 24 postoperative hours. Secondary outcomes include pain intensity at predefined postoperative time points, both at rest and with movement; time to first request for rescue analgesia; intraoperative and postoperative hemodynamic changes; recovery time; patient satisfaction; and adverse effects, including nausea, vomiting, respiratory depression, and complications related to the regional anesthesia technique.
The study will evaluate whether the QL block provides superior postoperative analgesia and opioid-sparing effects compared with the EO plane block following open nephrectomy.
- Conditions
- Postoperative Pain
- Being tested
- Quadratus Lumborum Block (QLB), External Oblique Plane Block
- Keywords
- Nephrectomy, Quadratus Lumborum Block, Regional Anesthesia
- Medical subject headings
- Pain, Postoperative
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Quadratus Lumborum Block (QLB)Procedure or surgery
Ultrasound-guided transmuscular quadratus lumborum block using 30 mL of 0.25% bupivacaine administered before induction of general anesthesia.
External Oblique Plane BlockProcedure or surgery
Ultrasound-guided external oblique plane block using 30 mL of 0.25% bupivacaine administered before induction of general anesthesia.
| Study group | Role | What they receive |
|---|---|---|
| Quadratus Lumborum Block (QL) | Experimental | Participants will receive an ultrasound-guided transmuscular quadratus lumborum block before induction of general anesthesia. A total of 30 mL of 0.25% bupivacaine will be administered in the fascial plane between the quadratus lumborum and psoas major muscles. Participants will also receive the standardized general anesthesia and postoperative multimodal analgesia described in the study protoco Receives: Procedure: Quadratus Lumborum Block (QLB) |
| External Oblique Plane Block (EO) | Experimental | Participants will receive an ultrasound-guided external oblique plane block before induction of general anesthesia. A total of 30 mL of 0.25% bupivacaine will be administered in the fascial plane between the external oblique and intercostal muscles. Participants will also receive the standardized general anesthesia and postoperative multimodal analgesia described in the study protocol. Receives: Procedure: External Oblique Plane Block |
What is being measured
The primary outcome is the main question the study is designed to answer.
24-hour postoperative morphine consumption
Total amount of intravenous morphine administered as rescue analgesia during the first 24 hours after surgery. Morphine consumption will be recorded for each participant and compared between the quadratus lumborum block and external oblique plane block groups.
Measured: First 24 hours after surgery
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted26 Aug 2026
- Study start1 Apr 2026
- Primary completion1 Apr 2027 (estimated)
- Study completion1 May 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Postoperative 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
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Participants will be randomly assigned in a 1:1 ratio to one of two parallel intervention groups: transmuscular quadratus lumborum block or external oblique plane block.
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 54 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Sayed Mahmoud Abed, Cairo University
- Investigators
- Mona H Abdelhamid, MD, Principal investigator, Professor of anesthesia
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07787221
- Sponsor's protocol ID
- QL block vs EOB in nephrectomy
- Status last verified
- Aug 2026
- First submitted
- 24 Aug 2026
- Last updated
- 1 Sep 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Individual participant data will not be shared with other researchers because no data-sharing plan has been established for this study. Study data will be used by the research team for the purposes of the current study, in accordance with applicable ethical and institutional requirements.
Publications
Blanco R, Ansari T, Girgis E. Quadratus lumborum block for postoperative pain after caesarean section: A randomised controlled trial. Eur J Anaesthesiol. 2015 Nov;32(11):812-8. doi: 10.1097/EJA.0000000000000299.
PubMed 26225500Elsharkawy H, El-Boghdadly K, Barrington M. Quadratus Lumborum Block: Anatomical Concepts, Mechanisms, and Techniques. Anesthesiology. 2019 Feb;130(2):322-335. doi: 10.1097/ALN.0000000000002524. No abstract available.
PubMed 30688787Blanco R. TAP block under ultrasound guidance: the description of a "non-pops technique." Reg Anesth Pain Med. 2007;32(2):130.
Study at a glance
From the registry record, last updated by the sponsor on 1 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Quadratus Lumborum Block Versus External Oblique Plane Block for Analgesia After Open Nephrectomy: A Prospective Randomized Clinical Trial
- ClinicalTrials.gov ID
- NCT07787221
- Acronym / sponsor ID
- QL block vs EOB in nephrectomy
- Conditions
- Postoperative Pain
- Keywords
- Nephrectomy, Quadratus Lumborum Block, Regional Anesthesia
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 54 participants (estimated)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- 1 Apr 2026 (actual)
- Primary completion
- 1 Apr 2027 (estimated)
- Study completion
- 1 May 2027 (estimated)
- First posted
- 26 Aug 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 prospective randomized clinical trial aims to compare two ultrasound-guided regional anesthesia techniques, the transmuscular quadratus lumborum (QL) block and the external oblique (EO) plane block, for pain relief after open nephrectomy. Open nephrectomy is a major surgical procedure that can cause significant postoperative pain and may require opioid medications for adequate pain control.
Adult patients undergoing open nephrectomy at the National Cancer Institute, Cairo University, who meet the study eligibility criteria will be randomly assigned to receive either a QL block or an EO plane block before surgery. Both techniques will be performed under ultrasound guidance using bupivacaine in addition to standardized general anesthesia and multimodal postoperative analgesia.
The main purpose of the study is to determine whether the QL block provides better postoperative analgesia than the EO plane block. The primary outcome will be the total amount of intravenous morphine consumed during the first 24 hours after surgery. Secondary outcomes will include postoperative pain scores, time to first request for rescue analgesia, hemodynamic changes, recovery time, patient satisfaction, and adverse effects related to analgesia or the regional anesthesia techniques.
A total of 54 patients will be enrolled and randomly allocated equally between the two treatment groups.
Detailed description
The study is a prospective, randomized clinical trial designed to compare the analgesic efficacy of the transmuscular quadratus lumborum block with the external oblique plane block in adult patients undergoing open nephrectomy.
Open nephrectomy is associated with substantial postoperative pain because of the extent of the surgical incision, muscular dissection, and manipulation of retroperitoneal structures. Effective postoperative analgesia is important to facilitate recovery, mobilization, respiratory function, and patient comfort while minimizing opioid requirements.
The quadratus lumborum block is a posterior abdominal wall fascial plane block in which local anesthetic is deposited in relation to the quadratus lumborum muscle. The technique may provide analgesia over several thoracoabdominal dermatomes and may have both somatic and visceral analgesic effects. The external oblique plane block is a more superficial fascial plane technique that targets the lateral abdominal wall and may provide effective somatic analgesia.
Eligible patients will be randomly allocated in a 1:1 ratio to receive either a transmuscular QL block or an EO plane block before induction of general anesthesia. All patients will receive standardized general anesthesia and multimodal postoperative analgesia. The regional blocks will be performed under ultrasound guidance by an experienced anesthesiologist.
The primary outcome is total intravenous morphine consumption during the first 24 postoperative hours. Secondary outcomes include pain intensity at predefined postoperative time points, both at rest and with movement; time to first request for rescue analgesia; intraoperative and postoperative hemodynamic changes; recovery time; patient satisfaction; and adverse effects, including nausea, vomiting, respiratory depression, and complications related to the regional anesthesia technique.
The study will evaluate whether the QL block provides superior postoperative analgesia and opioid-sparing effects compared with the EO plane block following open nephrectomy.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
- Model description
- Participants will be randomly assigned in a 1:1 ratio to one of two parallel intervention groups: transmuscular quadratus lumborum block or external oblique plane block.
| Arm | Type | Receives |
|---|---|---|
| Quadratus Lumborum Block (QL) | Experimental | Procedure: Quadratus Lumborum Block (QLB)Participants will receive an ultrasound-guided transmuscular quadratus lumborum block before induction of general anesthesia. A total of 30 mL of 0.25% bupivacaine will be administered in the fascial plane between the quadratus lumborum and psoas major muscles. Participants will also receive the standardized general anesthesia and postoperative multimodal analgesia described in the study protoco |
| External Oblique Plane Block (EO) | Experimental | Procedure: External Oblique Plane BlockParticipants will receive an ultrasound-guided external oblique plane block before induction of general anesthesia. A total of 30 mL of 0.25% bupivacaine will be administered in the fascial plane between the external oblique and intercostal muscles. Participants will also receive the standardized general anesthesia and postoperative multimodal analgesia described in the study protocol. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Adult patients aged 18 to 65 years.
- Patients undergoing open nephrectomy at the National Cancer Institute, Cairo University.
- American Society of Anesthesiologists (ASA) physical status II-III.
- Body mass index (BMI) greater than 20 kg/m² and less than 35 kg/m².
Key exclusion criteria (8 listed)
- Patient refusal to participate.
- ASA physical status IV.
- Age less than 18 years or greater than 65 years.
- BMI less than 20 kg/m² or greater than 35 kg/m².
- Known allergy or contraindication to any study medication, including local anesthetics or opioids.
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 |
|---|---|---|
| Quadratus Lumborum Block (QLB)Ultrasound-guided transmuscular quadratus lumborum block using 30 mL of 0.25% bupivacaine administered before induction of general anesthesia. | Procedure or surgery | Quadratus Lumborum Block (QL) |
| External Oblique Plane BlockUltrasound-guided external oblique plane block using 30 mL of 0.25% bupivacaine administered before induction of general anesthesia. | Procedure or surgery | External Oblique Plane Block (EO) |
Primary outcome
24-hour postoperative morphine consumption
Time frame: First 24 hours after surgery
Total amount of intravenous morphine administered as rescue analgesia during the first 24 hours after surgery. Morphine consumption will be recorded for each participant and compared between the quadratus lumborum block and external oblique plane block groups.
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 1 Sep 2026.
- Background: PubMed 26225500Blanco R, Ansari T, Girgis E. Quadratus lumborum block for postoperative pain after caesarean section: A randomised controlled trial. Eur J Anaesthesiol. 2015 Nov;32(11):812-8. doi: 10.1097/EJA.0000000000000299.
- Background: PubMed 30688787Elsharkawy H, El-Boghdadly K, Barrington M. Quadratus Lumborum Block: Anatomical Concepts, Mechanisms, and Techniques. Anesthesiology. 2019 Feb;130(2):322-335. doi: 10.1097/ALN.0000000000002524. No abstract available.
- Results publicationBlanco R. TAP block under ultrasound guidance: the description of a "non-pops technique." Reg Anesth Pain Med. 2007;32(2):130.
- Individual participant dataSharing planned: No. Individual participant data will not be shared with other researchers because no data-sharing plan has been established for this study. Study data will be used by the research team for the purposes of the current study, in accordance with applicable ethical and institutional requirements.
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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.
Mona H Abdelhamid, MD principal investigator
Professor of anesthesia
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Quadratus Lumborum Block (QLB) and External Oblique Plane Block in people with Postoperative Pain, run by Cairo University 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 8 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 1 Sep 2026. 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?
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 Sayed M Abed, MD (002-01226806532, sayed.abed@nci.cu.edu.eg), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
24-hour postoperative morphine consumption (time frame: First 24 hours after surgery). 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 NCT07787221, which also lists 3 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 1 Sep 2026.