[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100648322":3},{"organization":4,"armGroups":7,"interventions":24,"overallOfficials":41,"centralContacts":41,"locations":42,"responsibleParty":61,"collaborators":41,"id":65,"slug":66,"hasResults":67,"nctId":68,"briefTitle":69,"officialTitle":70,"acronym":41,"eligibilityCriteria":71,"healthyVolunteers":67,"sex":72,"minAge":73,"maxAge":74,"enrollmentInfo":75,"targetDuration":41,"studyType":78,"phases":79,"briefSummary":81,"conditions":82,"keywords":85,"overallStatus":45,"whyStopped":41,"lastUpdateSubmitDate":89,"lastUpdatePostDateStruct":90,"startDateStruct":93,"completionDateStruct":95,"leadSponsor":97,"locationsCount":98},{"fullName":5,"class":6},"Sohag University","OTHER",[8,14,19],{"label":9,"type":10,"description":11,"interventionNames":12},"Intrathecal morphine alone","ACTIVE_COMPARATOR","Drug: Intrathecal Morphine (ITM) Under sterile conditions preoperatively, a 25-gauge spinal needle is introduced at the L3-L4 or L2-L3 interspace. A 1.0 mL solution containing 100 µg of preservative-free morphine (diluted with 0.9% normal saline) is injected intrathecally upon free CSF flow. No ESPB is performed.",[13],"Drug: Intrathecal Morphine",{"label":15,"type":10,"description":16,"interventionNames":17},"Bilateral Erector Spinae Plane Block","Procedure: Bilateral Erector Spinae Plane Block Preoperatively, using a high-frequency linear ultrasound probe at the T8 vertebral level, an echogenic needle is inserted in-plane deep to the erector spinae muscle and superficial to the transverse process. After negative aspiration, 20 mL of 0.25% isobaric bupivacaine is injected. The procedure is repeated on the opposite side. No ITM is performed.",[18],"Procedure: Erector Spinae Plane Block",{"label":20,"type":21,"description":22,"interventionNames":23},"Intrathecal morphine + Bilateral Erector Spinae Plane Block","EXPERIMENTAL","Combination Regimen Patients receive both interventions preoperatively. The bilateral T8 ESPB (20 mL 0.25% bupivacaine per side) is performed first in the lateral decubitus position, followed immediately by the lumbar L2-L3 or L3-L4 ITM injection (100 mcg preservative-free morphine).",[13,18],[25,33],{"type":26,"name":27,"description":28,"armGroupLabels":29,"otherNames":30},"DRUG","Intrathecal Morphine","Administration of a single-shot intrathecal injection containing hyperbaric bupivacaine combined with preservative-free morphine (ITM) during spinal anesthesia prior to the surgical incision.\"",[20,9],[31,32],"ITM","Spinal Morphine",{"type":34,"name":35,"description":36,"armGroupLabels":37,"otherNames":38},"PROCEDURE","Erector Spinae Plane Block","Bilateral ultrasound-guided erector spinae plane block performed at the T8-T10 level using a local anesthetic solution (such as bupivacaine or ropivacaine) injected deep to the erector spinae muscle fascia for postoperative abdominal analgesia.",[15,20],[39,40],"ESBP","Ultrasound-guided ESPB",null,[43],{"facility":44,"status":45,"city":46,"state":41,"zip":41,"country":47,"countryCode":48,"cosmosGeoPoint":49,"geoPoint":54,"contacts":55},"Sohag University Hospital","RECRUITING","Sohag","Egypt","EG",{"type":50,"coordinates":51},"Point",[52,53],31.69478,26.55695,{"lat":53,"lon":52},[56],{"name":57,"role":58,"phone":59,"phoneExt":41,"email":60},"Ahmed Samir Abdelmonaem, Resident doctor","CONTACT","+201022447409","ahmed.abdelmonem@med.sohag.edu.eg",{"type":62,"investigatorFullName":63,"investigatorTitle":64,"investigatorAffiliation":5,"oldNameTitle":41,"oldOrganization":41},"PRINCIPAL_INVESTIGATOR","Ahmed Samir Abdelmonaem","Resident of Anesthesia, Surgical Intensive Care and Pain management","100648322","efficacy-of-adding-intrathecal-morphine-to-erector-spinae-plane-block-for-postoperative-analgesia-after-midline-laparotomy-100648322",false,"NCT07720739","Efficacy of Adding Intrathecal Morphine to Erector Spinae Plane Block for Postoperative Analgesia After Midline Laparotomy","Efficacy of Adding Intrathecal Morphine to Erector Spinae Plane Block for Postoperative Analgesia After Midline Laparotomy: A Prospective Randomized Study","Inclusion Criteria Patients scheduled to undergo elective or emergency midline exploratory laparotomy.\n\nAmerican Society of Anesthesiologists (ASA) physical status I, II, or III. Intact cognitive ability to comprehend study procedures, use the Numeric Rating Scale (NRS) accurately, and provide informed consent.\n\nExclusion Criteria Contraindications to regional or neuraxial anesthesia (e.g., patient refusal, localized infection at needle insertion sites, known coagulopathy (INR \\>1.5 or platelet count \\\u003C80,000\u002F\\\\mu L), or un-pausable therapeutic anticoagulation).\n\nKnown allergy or severe hypersensitivity to local anesthetics or morphine. Chronic pain conditions requiring daily opioid consumption for \\>3 months preoperatively.\n\nDocumented history of substance use disorder. Severe chronic respiratory disease (e.g., COPD requiring home oxygen therapy, or severe obstructive sleep apnea not managed with CPAP).\n\nNeurological or psychiatric conditions that compromise sensory perception or communication.\n\nSurgical incisions planned to extend significantly past the midline. Severe spinal deformities or a history of spinal surgery at the targeted block\u002Finjection interspaces.\n\nConcurrent enrollment in any other interventional clinical trial.","ALL","18 Years","60 Years",{"count":76,"type":77},75,"ESTIMATED","INTERVENTIONAL",[80],"NA","This study evaluates whether combining two distinct pain-relief techniques-a peripheral nerve block called the Erector Spinae Plane Block (ESPB) and a low-dose spinal medication injection called Intrathecal Morphine (ITM)-provides better postoperative pain management for adult patients undergoing major midline abdominal surgery (laparotomy) compared to using either technique alone. The main goal is to see if this combination improves pain control and reduces the total amount of opioids required by patients within the first 48 hours after surgery.",[83,84],"Postoperative Pain","Midline Laparotomy",[35,86,87,88],"Intrathecal morphine","Opioid-sparing","Abdominal surgery","2026-07-19",{"date":91,"type":92},"2026-07-22","ACTUAL",{"date":94,"type":77},"2026-07",{"date":96,"type":77},"2026-12",{"name":5,"class":6},1]