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Ultrasound-Guided Midpoint Transverse Process to Pleura Block Versus Erector Spinae Plane Block for Postoperative Analgesia in Patients Undergoing Open Renal Surgery :A Randomized Comparative Study.
Sponsor: Minia University
Summary
The goal of this randomized comparative clinical trial is to compare the analgesic effectiveness of ultrasound-guided Midpoint Transverse Process to Pleura (MTP) block versus Erector Spinae Plane (ESP) block in adult patients undergoing open renal surgery. The main question it aims to answer is: Does MTP block provide postoperative analgesia comparable to ESP block, as assessed by postoperative opioid consumption and pain scores? Researchers will compare MTP block with ESP block to evaluate postoperative opioid consumption, pain intensity, time to first rescue analgesia, and the incidence of adverse events. Participants will receive general anesthesia followed by either ultrasound-guided MTP block or ESP block before surgery. Postoperative pain and opioid consumption will be assessed for 24 hours after surgery.
Key Details
Gender
All
Age Range
18 Years - 65 Years
Study Type
INTERVENTIONAL
Enrollment
50
Start Date
2026-11-01
Completion Date
2027-12-01
Last Updated
2026-10-19
Healthy Volunteers
No
Interventions
Midpoint Transverse Process to Pleura (MTP)Block
After induction of general anesthesia, the patient will be positioned laterally. Under aseptic precautions, a high-frequency linear ultrasound probe will be placed parasagittally at T9, 2-3 cm lateral to the midline. The transverse process and pleura will be identified. Using an in-plane cranial-to-caudal approach, a 22-G echogenic needle will be advanced to the midpoint between the transverse process and pleura. After negative aspiration and hydrodissection with 1-2 mL saline, 30 mL of 0.25% bupivacaine will be injected incrementally under continuous ultrasound visualization.
Erector spinae plane (ESP) block
After induction of general anesthesia, the patient will be positioned laterally with the operative side uppermost. Under aseptic precautions, a high-frequency linear ultrasound probe will be placed parasagittally at T9, 2-3 cm lateral to the midline to identify the transverse process and overlying muscles. Using an in-plane cranial-to-caudal approach, a 22-G echogenic needle will be advanced deep to the erector spinae muscle and superficial to the transverse process. After negative aspiration and hydrodissection with 1-2 mL saline, 30 mL of 0.25% bupivacaine will be injected incrementally under continuous ultrasound visualization, confirming appropriate fascial spread.
Locations (1)
Nephrology and Urology Minia University Hospital
Minya, Minya Governorate, Egypt