NCT07496086

External Oblique Intercostal Block Versus Transversus Abdominis Plane Combined With Rectus Sheath Block on Postoperative Pain in Laparoscopic Radical Gastrectomy

Effects of Ultrasound-guided External Oblique Intercostal Block Versus Transversus Abdominis Plane Combined With Rectus Sheath Block on Postoperative Pain in Laparoscopic Radical Gastrectomy

• Status: Recruiting
• Phase: N/A
• Study type: Interventional
• Enrollment: 100 (estimated)
• Sponsor: General Hospital of Ningxia Medical University · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

Postoperative pain is highly prevalent following laparoscopic radical gastrectomy. Although Transversus abdominis plane block combined with rectus sheath block(TAP+RSB） can effectively alleviate this pain, it still has many limitations. The external oblique intercostal plane block (EOIB) is a novel nerve block technique that may provide well postoperative analgesia for upper abdominal surgery. Therefore, this study employs a non-inferiority randomized controlled trial design to verify that the analgesic effect of EOIB is not inferior to that of ESPB, thereby offering more options for regional analgesia strategies in laparoscopic radical gastrectomy.

Detailed description

Laparoscopic radical gastrectomy (including subtotal and total gastrectomy) is the most commonly used surgical approach for gastric cancer. Although this technique is less invasive than traditional open surgery, more than 50% of patients still experience moderate to severe acute pain in the early postoperative period, making effective postoperative pain management essential. Regional nerve blockade techniques have become a key component of postoperative analgesia due to their reliable analgesic effect and significant reduction in opioid consumption. The transversus abdominis plane block combined with rectus sheath block(TAP+RSB) is considered a relatively safe nerve block for upper abdominal surgery analgesia. However, the spread of the local anesthetic and the resulting block effect are unpredictable. The external oblique intercostal plane block (EOIB) is a recently proposed regional block technique for the upper abdomen. This block involves injecting local anesthetic into the superficial fascial plane between the external oblique muscle and the intercostal muscles, thereby blocking the anterior rami and cutaneous branches of the intercostal nerves from T6-T10, which can provide effective analgesia for upper abdominal incision areas. Nevertheless, current research on the analgesic effect of EOIB after laparoscopic radical gastrectomy remains limited, particularly lacking high-quality, prospective, randomized controlled studies to verify whether EOIB can achieve analgesic effects comparable to those of TAP+RSB， Therefore, this study adopts a non-inferiority randomized controlled trial design to verify that the postoperative analgesic effect of EOIB is better than TAP+RSB, providing more options for regional analgesia strategies in laparoscopic radical gastrectomy.

Conditions

• Postoperative Pain

Interventions

Type	Name	Description
PROCEDURE	EOIB	With the patient in the supine position, a high-frequency linear array probe (6-15 MHz) is used to perform a sagittal parasagittal oblique scan at the level of the 6th rib, between the right anterior axillary line and midclavicular line. The external oblique muscle, intercostal muscles, and ribs are identified. Using an in-plane technique, a 21G, 100mm block needle is inserted from a superomedial to inferolateral direction, with the needle tip positioned in the plane between the external oblique muscle and the intercostal muscles at the caudal edge of the 6th rib. 30ml of 0.375% ropivacaine is injected on each side, for a bilateral administra
PROCEDURE	TAP+RSB	With the patient in the supine position, above the umbilicus, a linear ultrasound transducer was positioned transversely on the rectus abdominis muscle, and 15 mL of ropivacaine 0.375% was injected into both sides of the aspect between the rectus abdominis muscle and the posterior rectus sheath with a 22G 70-mm block needle using the in-plane technique. At the midaxillary line, a linear ultrasound transducer was positioned close and parallel to the lower costal margin. In the bilateral aspect between the internal oblique and transversus abdominis muscles, 15 mL of ropivacaine 0.375% was injected on each side with a 22G 70-mm block needle.

Timeline

• Start date: 2026-03-20
• Primary completion: 2026-10-30
• Completion: 2026-11-03
• First posted: 2026-03-27
• Last updated: 2026-03-27

Locations

1 site across 1 country: China