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EOI Block vs. TAP Block in Minimally Invasive Hepatectomy

ConditionHepatectomy
Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age20-80
SponsorSeoul National University Hospital

About this trial

This study aims to compare the analgesic efficacy of two different ultrasound-guided nerve blocks-the External Oblique Intercostal (EOI) block and the Subcostal Transversus Abdominis Plane (TAP) block-in patients undergoing minimally invasive hepatectomy. All participants will receive standardized general anesthesia and perioperative care at Seoul National University Hospital. Following anesthesia induction, patients will be randomly assigned to receive either an EOI block or a subcostal TAP block with 0.375% ropivacaine to provide regional pain relief. Postoperative pain will be managed using a combination of scheduled non-opioid analgesics and a fentanyl-based patient-controlled analgesia (PCA) device. The primary objective is to evaluate which regional technique more effectively reduces cumulative opioid consumption during the first 24 hours after surgery. Additionally, the study will assess pain intensity using the Numerical Rating Scale (NRS), the incidence of postoperative nausea and vomiting, and the overall recovery profile, including the time to first ambulation.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

None

Disqualifiers

American Society of Anesthesiologists physical status IV or higher

History of chronic pain or current use of analgesics, antidepressants, or anticonvulsants for pain management

Known hypersensitivity to general anesthetics, opioids, or local anesthetics

Conversion to open hepatectomy

Trial design

Design model

Parallel

Treatments tested in this trial

  • External Oblique Intercostal Block

    Procedure/Surgery

    Following the induction of general anesthesia, patients in this group will receive an ultrasound-guided bilateral external intercostal fascial plane block. A total of 40 mL of 0.375% ropivacaine (20 mL per side) will be injected into the plane between the external intercostal muscle and the internal intercostal muscle at the T6-7 or T7-8 level.

  • TAP Block

    Procedure/Surgery

    Following the induction of general anesthesia, patients in this group will receive an ultrasound-guided bilateral subcostal transversus abdominis plane block. A total of 40 mL of 0.375% ropivacaine (20 mL per side) will be injected into the fascial plane between the internal oblique and transversus abdominis muscles along the subcostal margin.

Treatment groups

140 Participants
are divided into 2 treatment groups
Group A: External Oblique Intercostal (EOI) block groupExperimental treatment 1 intervention
Group B: Transversus Abdominis Plane (TAP) block groupActive comparator 1 intervention

Trial outcomes

Primary outcomes

1

Cumulative opioid consumption at 24 hours postoperatively

The total amount of intravenous fentanyl administered via patient-controlled analgesia (PCA) and as rescue boluses will be recorded and converted to intravenous morphine equivalents for standardized comparison.

Time frame
From the end of surgery up to 24 hours postoperatively

Secondary outcomes

1

Cumulative Opioid Consumption at 1, 6, 12, and 48 hours postoperatively

Total amount of fentanyl administered via IV-PCA and rescue boluses. All doses will be recorded and analyzed at each specified time point.

Time frame
1, 6, 12, and 48 hours after surgery completion.
2

Postoperative pain intensity measured by Numerical Rating Scale (NRS)

Pain intensity is assessed using a scale from 0 to 10, where 0 indicates "no pain" and 10 indicates "the worst pain imaginable."

Time frame
During Post-Anesthesia Care Unit (PACU) stay, and at 24 and 48 hours postoperatively.
3

Total dose of intraoperative remifentanil

Total administered dose of intraoperative remifentanil (mcg) measured from anesthesia induction to skin closure.

Time frame
During the intraoperative period (from induction to skin closure).
4

Incidence of Postoperative Nausea and Vomiting

The presence or absence of postoperative nausea and vomiting episodes (dichotomous outcome: yes/no) will be recorded.

Time frame
Up to 48 hours postoperatively.

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Seoul National University Hospital

Lead sponsor

Source ClinicalTrials.gov

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