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

NCT06983249 · Status: ACTIVE_NOT_RECRUITING · Phase: NA · Type: INTERVENTIONAL · Enrollment: 50

Last updated 2025-09-11

No results posted yet for this study

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.

Conditions

  • Open Nephrectomy Surgery

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

Sponsors & Collaborators

  • Ain Shams University

    lead OTHER

Study Design

Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Model
PARALLEL

Eligibility

Min Age
40 Years
Max Age
70 Years
Sex
ALL
Healthy Volunteers
No

Timeline & Regulatory

Start
2025-07-01
Primary Completion
2026-09-01
Completion
2026-09-01

Countries

  • Egypt

Study Locations

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Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT06983249 on ClinicalTrials.gov