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Background <p>Nephrectomy procedures result in considerable postoperative discomfort, and limitations on the use of traditional management include opioid-related adverse effects and epidural-associated side effects. A prospective comparison was conducted to evaluate the relative effectiveness of two regional anesthetic techniques, the external oblique intercostal plane block (EOIPB) and the ultrasound-guided posterior transversus abdominis plane block (TAPB), in reducing postsurgical pain after open nephrectomy (OPN).</p> Methods <p>Forty adults who underwent elective OPN were included in the study. The study population was randomly divided into two groups to receive either EOIPB or TAPB in a volume of 20 mL with 0.5% bupivacaine after the induction phase. The primary outcome was cumulative 24-hour pethidine consumption. Secondary outcomes included intraoperative fentanyl requirements, time to first rescue analgesia, pain scores at 0, 4, 8, 12, 18, and 24&#xa0;h postoperatively, hemodynamic parameters, adverse events, and patient satisfaction.</p> Results <p>The EOIPB group had significantly lower pain scores at 4, 8, 12, and 18&#xa0;h after surgery compared to the TAPB group (<i>p</i> &lt; 0.05). The EOIPB group used significantly less pethidine than the other group (61.5 ± 24.77&#xa0;mg vs. 114 ± 12.31&#xa0;mg, <i>p</i> &lt; 0.001), and it took them longer to receive their first rescue analgesia (7.25 ± 0.91 vs. 6.1 ± 1.55&#xa0;h, <i>p</i> = 0.007). The EOIPB group exhibited significantly higher patient satisfaction (<i>p</i> = 0.045), although the two groups had similar profiles of adverse events.</p> Conclusions <p>In adults undergoing OPN, EOIPB provided superior early postoperative analgesia compared to TAPB during the first 18&#xa0;h after surgery, as evidenced by lower pain scores, reduced opioid requirements, delayed time first to rescue analgesia, and higher patient satisfaction. Both blocks demonstrated comparable safety profiles.</p> Clinical trial <p>Registration occurring at ClinicalTrials.gov (ID: NCT06452238), (URL: <a href="https://clinicaltrials.gov/study/NCT06452238?cond=NCT06452238%26rank=1">https://clinicaltrials.gov/study/NCT06452238?cond=NCT06452238&amp;rank=1</a>), Date: (30-5-2024).</p>

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Ultrasound guided external oblique intercostal plane block versus posterior transversus abdominis plane block for postoperative analgesia in adult patients undergoing open nephrectomy: a randomized trial

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月7日

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  • Amgad Elshikh,
  • Lashin S. Ali,
  • Mohammed S. ElSharkawy,
  • Sameh M. Fathy,
  • Bahaa G. Mohamed,
  • Khaled Hamama,
  • Mahmoud A. Elmohasseb,
  • Eman H. Abu Shanab,
  • Zainab T. Ragab,
  • Saad A. Moharam,
  • Ahmed F. Mady

摘要

Background

Nephrectomy procedures result in considerable postoperative discomfort, and limitations on the use of traditional management include opioid-related adverse effects and epidural-associated side effects. A prospective comparison was conducted to evaluate the relative effectiveness of two regional anesthetic techniques, the external oblique intercostal plane block (EOIPB) and the ultrasound-guided posterior transversus abdominis plane block (TAPB), in reducing postsurgical pain after open nephrectomy (OPN).

Methods

Forty adults who underwent elective OPN were included in the study. The study population was randomly divided into two groups to receive either EOIPB or TAPB in a volume of 20 mL with 0.5% bupivacaine after the induction phase. The primary outcome was cumulative 24-hour pethidine consumption. Secondary outcomes included intraoperative fentanyl requirements, time to first rescue analgesia, pain scores at 0, 4, 8, 12, 18, and 24 h postoperatively, hemodynamic parameters, adverse events, and patient satisfaction.

Results

The EOIPB group had significantly lower pain scores at 4, 8, 12, and 18 h after surgery compared to the TAPB group (p < 0.05). The EOIPB group used significantly less pethidine than the other group (61.5 ± 24.77 mg vs. 114 ± 12.31 mg, p < 0.001), and it took them longer to receive their first rescue analgesia (7.25 ± 0.91 vs. 6.1 ± 1.55 h, p = 0.007). The EOIPB group exhibited significantly higher patient satisfaction (p = 0.045), although the two groups had similar profiles of adverse events.

Conclusions

In adults undergoing OPN, EOIPB provided superior early postoperative analgesia compared to TAPB during the first 18 h after surgery, as evidenced by lower pain scores, reduced opioid requirements, delayed time first to rescue analgesia, and higher patient satisfaction. Both blocks demonstrated comparable safety profiles.

Clinical trial

Registration occurring at ClinicalTrials.gov (ID: NCT06452238), (URL: https://clinicaltrials.gov/study/NCT06452238?cond=NCT06452238&rank=1), Date: (30-5-2024).