External Oblique Intercostal Block Versus Paravertebral Block for Postoperative Analgesia in Laparoscopic Cholecystectomy Patients

Anesthesia Clinical Trial

Official title:

External Oblique Intercostal Block Versus Paravertebral Block for Postoperative Analgesia in Laparoscopic Cholecystectomy Patients

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT06201364
• Other study ID #: External oblique intercostal
• Status: Not yet recruiting
• Phase: Phase 3
• Start date: February 1, 2024
• Est. completion date: August 1, 2025

Study information

• Verified date: January 2024
• Source: Assiut University
• Contact: Mohamed A Abd-Elkareem, MD
• Phone: 01050727722
• Email: mohamedadelkareem[@]aun.edu.eg
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

To compare external oblique intercostal block versus paravertebral block for post operative analgesia in patients undergoing laparoscopic cholecystectomy to decease post operative opioid consumption and use the least dose of local anesthesia.

Description:

Paravertebral Block (PVB) involve injection of local anesthetic in a space immediately lateral to where the spinal nerves emerge from the intervertebral foramina. This technique is being used increasingly for not only intra-operative and post-operative analgesia but also as a sole anesthetic technique for carrying out various procedures. This popularity is mainly due to the ease of the technique and fewer complications. The external oblique intercostal block is a novel motor- and opioid-sparing technique which blocks both the anterior and lateral cutaneous branches of the thoracoabdominal nerves which innervate the upper abdominal quadrant.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 80
• Est. completion date: August 1, 2025
• Est. primary completion date: June 30, 2025
• Accepts healthy volunteers: No
• Gender: All
• Age group: 20 Years to 60 Years

Eligibility

Inclusion Criteria:

• Patients between 20-60 years old
• Patients with ASA clinical status I\II
• Patients schedule for laparoscopic cholecystectomy

Exclusion Criteria:

• Patients refusal
• Coagulopathy
• Infection at site of injection
• Allergy of local anesthesia
• Sever cardiac disease
• Patients with chest wall deformities

Related Conditions & MeSH terms

• Anesthesia

Intervention

Procedure:
• The external oblique intercostal block
chest wall will be systematically scanned. Initially the probe will be placed in a cephalad to caudad paramedian direction at the anterior axillary line, and the external oblique muscle will be identified at the level ribs 6 and 7 in line with the xiphoid process to confirm correct identification of the external oblique muscle, the probe will be moved in the caudad direction following the external oblique muscle. At the subcostal level, the ultrasound probe will be rotated 90° to see the convergence with the internal oblique and transversus abdominus muscles. The probe will be then moved back to the initial identification point for the external oblique muscle. The EOI plane will be identified deep to the external oblique muscle and superficial to the sixth and seventh ribs and their associated intercostal muscles. Local anesthetic agent will be 20 ml volume (10 ml bupivacaine, 10 ml saline) will be injected under ultrasound guidance and this will be done bilaterally.
• Paravertebral block
involve injection of local anaesthetic in a space immediately lateral to where the spinal nerves emerge from the intervertebral foramina. This technique is being used increasingly for not only intra-operative and post-operative analgesia but also as a sole anaesthetic technique for carrying out various procedures.

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Assiut University

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	total morphine consumption		first 24 hours postoperatively
Secondary	Time of first rescue analgesia	rescue analgesia will be given in the form of morphine 4 mg when VAS score =4	hours
Secondary	Visual analogue scale (VAS)	It is a validated subjective measure for acute and chronic pain. Scores are recorded by making a handwritten mark on a 10-cm line that represents a continuum between "no pain" and "worst pain."	at 0.5 ,1,2,4,8,12,24 hours postoperatively