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ACTIVE NOT RECRUITING
NCT06983249
NA

Rhomboid Intercostal and Subserratus Plane Block Versus Quadratus Lumborum Block in Management of Postoperative Pain After Open Nephrectomy

Sponsor: Ain Shams University

View on ClinicalTrials.gov

Summary

Rhomboid intercostal block (RIB) and Rhomboid intercostal block with sub-serratus plane block (RISS) are the two types of plane blocks used for postoperative analgesia after abdominal surgeries. For achieving proper postoperative analgesia, multimodal regimens have been described for patients undergoing abdominal procedures like cholecystectomy. These multimodal regimens could include opioid medications, non-opioid analgesics (e.g., acetaminophen and ketorolac), and regional blocks. These modalities could be used alone or in combination. This prospective randomised controlled trial was performed to analyse the postoperative analgesic effects of ultrasound guided Quadratus lumborum block and RISS block in managing post operative pain in patients undergoing open nephrectomy.

Key Details

Gender

All

Age Range

40 Years - 70 Years

Study Type

INTERVENTIONAL

Enrollment

50

Start Date

2025-07-01

Completion Date

2026-09-01

Last Updated

2025-09-11

Healthy Volunteers

No

Interventions

PROCEDURE

Rhomboid intercostal and Sub-serratus nerve block in nephrectomy

That block was performed when the patient was in the lateral position. A high frequency linear ultrasound transducer was placed longitudinally on the patient's back, just 2 cm medial to the medial scapular border. Then, the probe was slightly rotated to obtain an oblique parasagittal plane. The following landmarks were identified: the trapezius muscle, rhomboid major muscle, intercostal muscles, pleura, and lungs (from superficial to deep in order of appearance). Under ultrasound guidance, a 22 mm gauge spinal needle was directed to the plane by using high frequency ultrasound guidence (Sono SiteTM, Inc., Bothell, WA 98021, USA) between the rhomboid major and the underlying intercostal muscles and 15 ml bupivacaine (0.25%) was delivered into that plane (after repeated negative aspiration of blood), and its spread was manifested by the hydrodissection and widening of the plane visualized by ultrasound

PROCEDURE

Quadratus lumborum nerve block in nephrectomy

Ultrasound guided posterior quadrates lumborum block was done in lateral decubitus position and linear probe according to the depth was placed in the midaxillary line in the transverse plane immediately above the iliac crest and then it was slided dorsally until the "Shamrock sign" was clearly identified. In "Shamrock sign" The quadratus lumborum (QL) muscle is seen as a superior leaf of the Shamrock at the apex of the transverse process (TP) of L4

Locations (1)

Ainshams university

Cairo, Cairo Governorate, Egypt