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Bilevel Erector Spinae Plane Block Versus Transversus Abdominis Plane Block for Analgesia After Cesarean Delivery.

NCT07137208 · Status: COMPLETED · Phase: NA · Type: INTERVENTIONAL · Enrollment: 90

Last updated 2026-01-27

No results posted yet for this study

Summary

Optimizing analgesia after cesarian delivery is an essential element of enhancing maternal recovery.A multimodal analgesic approach incorporating truncal blocks can provide effective pain relief with minimal side effects for both mother and infant.The posterior TAP block may provide enhanced effect due to possible retrograde spread to the paravertebral space.The ESP block has emerged as a valuable component of multimodal pain management, providing effective postoperative analgesia for various surgeries, including cesarean delivery. We hypothesized that the bilevel ESP block will offer superior analgesic efficacy compared to the TAP block and may be a valuable addition to multimodal analgesic regimens targeting opioid use reduction.

Conditions

  • Cesarean Section Wound

Interventions

PROCEDURE

ESP block

In the ESP group, patients will be positioned in the right lateral position. The ultrasound probe will be placed vertically about 3 cm lateral to the spinous process of T9 to visualize the transverse process, trapezius, and erector spinae muscles. A 22-gauge spinal needle will be inserted in-plane in the cranial-to-caudal direction until the needle tip reaches the fascial plane between the erector spinae muscle and transverse process. Following hydrodissection with 2 mL of sterile saline to confirm needle placement, and negative aspiration to rule out intravascular placement, the local anesthetic will be injected. Likewise, the same block procedure will be performed at the T11 level and on both levels on the other side, 10 mL will be injected at each of the four injection sites.

PROCEDURE

TAP Block

In the TAP group, patients will be positioned in the supine position. A posterior approach will be employed, with the ultrasound probe placed transversely on the anterolateral abdominal wall, midway between the costal margin and iliac crest, posterior to the midaxillary line. This will allow visualization of the external oblique, internal oblique, and transversus abdominis muscles. The probe will then be moved posteriorly to identify the tapering of the transversus abdominis muscle toward the quadratus lumborum. A 22-gauge spinal needle will be inserted in-plane from anterior to posterior. Following hydrodissection with 2 mL of sterile saline to confirm needle placement, and negative aspiration to rule out intravascular placement, the local anesthetic will be injected into the plane between the internal oblique and transversus abdominis muscles. Likewise, the same block procedure will be performed on the other side.

DRUG

Bupivacaine injection

A total of 20 mL of 0.25 bupivacaine will be administered at each side.

Sponsors & Collaborators

  • Mansoura University

    lead OTHER

Principal Investigators

  • Amany H Eldeeb · Faculty of Medicine, Mansoura University

Study Design

Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Model
PARALLEL

Eligibility

Min Age
19 Years
Max Age
40 Years
Sex
FEMALE
Healthy Volunteers
No

Timeline & Regulatory

Start
2025-10-01
Primary Completion
2025-12-30
Completion
2026-01-15

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 NCT07137208 on ClinicalTrials.gov