RecruitingNot ApplicableNCT07396545

External Oblique Intercostal Block Versus Erector Spinae Plane Block on Postoperative Pain in Laparoscopic Radical Gastrectomy

Effects of Ultrasound-guided External Oblique Intercostal Block Versus Erector Spinae Plane Block on Postoperative Pain in Laparoscopic Radical Gastrectomy

Sponsor

General Hospital of Ningxia Medical University

Enrollment

184 participants

Start Date

Mar 12, 2026

Study Type

INTERVENTIONAL

Conditions

Postoperative Pain

Summary

Postoperative pain is highly prevalent following laparoscopic radical gastrectomy. Although the erector spinae plane block (ESPB) 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.

Eligibility

Min Age: 18 Years

Inclusion Criteria4

Patients aged over 18 years
Classified as ASA I-III
Scheduled for elective laparoscopic radical gastrectomy under general anesthesia
Voluntarily participated and provided written informed consent.

Exclusion Criteria6

Chronic opioid dependence or prior use of analgesic medications for >3 months;
Inability to communicate due to severe dementia, language barriers, or terminal illness;
History of central and/or peripheral nervous system disorders;
Severe renal insufficiency (serum creatinine >442 μmol/L or requiring renal replacement therapy) or severe hepatic insufficiency (Child-Pugh class C);
Allergy to local anesthetics.
Expected to be transferred to ICU after surgery.

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Interventions

PROCEDUREExternal Oblique Intercostal Plane Block

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 administration.

PROCEDUREErector Spinae Plane Block (ESPB) group

With the patient in the lateral decubitus position (surgical side up), a low-frequency convex array probe (2-5 MHz) is used to perform a sagittal scan approximately 2-3 cm lateral to the spinous process of T8 or T9. The transverse process and the erector spinae muscle are identified. Using an out-of-plane technique, a 21G, 100mm block needle is advanced until contact is made with the transverse process. The needle is then withdrawn 1-2 mm to position its tip within the fascial plane deep to the erector spinae muscle and superficial to the transverse process. 30 ml of 0.375% ropivacaine is injected on each side, for a bilateral administration.