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CompletedNCT04110210Updated Aug 4, 2020

Effectiveness of Bilateral Ultrasound-Guided Erector Spinae Plane Block

An Early Phase 1 interventional study of Bilateral Ultrasound-Guided Erector Spinae Plane Block and Morphine Consumption in Erector Spinae Plane Block, sponsored by Cairo University. Completed at 1 site in Egypt. Open to participants aged 18 Years to 60 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2020-08-04.

Sponsored by Cairo University · Early Phase 1, Interventional, and Diagnostic

Phase
Early Phase 1
Study type
Interventional
Enrollment
34
Allocation
Randomized
Ages
18 Years to 60 Years
Sex
All
01

Study summary

The proposed mechanism of action of the ESPB is via blockade of the dorsal and ventral rami of the spinal nerves and sympathetic nerve fibers. Radiographic evidence suggests that local anesthetic injected into at the ESP spreads both cranially and caudally as the plane is continuous along the vertebral column . ESPB reportshave demonstrated analgesia at cervical, thoracic, and lumbar levels for procedures such aspyeloplasty, lipoma excision, breast reconstruction,malignant mesothelioma, inguinal hernia repairs, and hip reconstructions

Read the detailed description

One of these local analgesia is the erector spinae plane block (ESPB). it was first described in 2016 as a regional block for the treatment of thoracic neuropathic pain. This has shown promise as an alternative to neuraxial blockade for a variety of surgeries with good effect. In addition, the block has a reduced risk of epidural hematoma, direct spinal cord injury, and central infection .

The proposed mechanism of action of the ESPB is via blockade of the dorsal and ventral rami of the spinal nerves and sympathetic nerve fibers. Radiographic evidence suggests that local anesthetic injected into at the ESP spreads both cranially and caudally as the plane is continuous along the vertebral column . ESPB reportshave demonstrated analgesia at cervical, thoracic, and lumbar levels for procedures such aspyeloplasty, lipoma excision, breast reconstruction,malignant mesothelioma, inguinal hernia repairs, and hip reconstructions

02

Conditions studied

  • Erector Spinae Plane Block
03

In context

Lead sponsor

Cairo University is the lead sponsor of 4,780 studies on the registry; 1,427 are open to participants now.

Of its 36 completed or terminated interventional studies of FDA-regulated products, 5 (14%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 60 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • Patients aged from 18 to 60 years.
  • Genders eligible for study: both sexes.
  • ASA I-II.
  • Undergoing lumbar spine surgeries in any 2 levels(L1-L5).
  • BMI from 18.5 to 30 kg/m2

Exclusion criteria

Exclusion Criteria:

  • Patient refusal
  • Contraindications to regional anesthesia (Bleeding disorders, Use of any anti-coagulants, local infection, etc.).
  • Known allergy to local anesthetics.
  • ASA III-IV.
  • Patients aged less than 18 or more than 60.
  • Body mass index >35.
  • Patients with difficulty in evaluating their level of pain.
  • Patients with secondary surgery or surgery involving more than two intervertebral spaces were excluded.
05

Study design

Phase
Early Phase 1
Primary purpose
Diagnostic
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Care provider)
Enrollment
34 participants (actual)

Study arms

  • Active comparator
    Group A(Ultrasound guided ESP block after indtiucon of GA).

    Following skin sterilization and local anesthetic infiltration of the superficial tissues, an echogenic 22-G block needle is inserted in-plane to the ultrasound beam in a cranial-to-caudal direction until contact was made with the transverse process. Correct location of the needle tip in the fascial plane deep to erector spinae muscle is confirmed by injecting 0.5-1 ml saline and seeing the fluid lifting the erector spinae muscle off the transverse process while not distending the muscle. A total of 20ml bupivacaine 0.25% are then injected into the ESP. The procedure is repeated on the contralateral side.

    Drug: Bilateral Ultrasound-Guided Erector Spinae Plane Block

  • Active comparator
    Group B(GA with conventional analgesia)

    After operation, patients will be transferred to post anesthesia care unit (PACU) for complete recovery and monitoring. The pain VAS scores between the studied groups will be registered every 4 hours for 24 hours postoperatively. A standard postoperative analgesia regimen will be prescribed as paracetamol 1gm every 6 hours and ketorolac 30mg every 8 hours in the first 24 hours postoperatively. Morphine 2.5 mg will be given as a rescue analgesic dose if visual analogue score was ≥ 3 or when patient suffering from pain between the assessment intervals in both groups not exceeding 0.1 mg/kg in a period of 6 hours. Metoclopramide 0.15 mg/kg IV will be prescribed for patients complaining of nausea or vomiting.

    Drug: Morphine Consumption

Interventions

  • DrugBilateral Ultrasound-Guided Erector Spinae Plane Block

    Following skin sterilization and local anesthetic infiltration of the superficial tissues, an echogenic 22-G block needle is inserted in-plane to the ultrasound beam in a cranial-to-caudal direction until contact was made with the transverse process. Correct location of the needle tip in the fascial plane deep to erector spinae muscle is confirmed by injecting 0.5-1 ml saline and seeing the fluid lifting the erector spinae muscle off the transverse process while not distending the muscle. A total of 20ml bupivacaine 0.25% are then injected into the ESP. The procedure is repeated on the contralateral side.

  • DrugMorphine Consumption

    After operation, patients will be transferred to post anesthesia care unit (PACU) for complete recovery and monitoring. The pain VAS scores between the studied groups will be registered every 4 hours for 24 hours postoperatively. A standard postoperative analgesia regimen will be prescribed as paracetamol 1gm every 6 hours and ketorolac 30mg every 8 hours in the first 24 hours postoperatively. Morphine 2.5 mg will be given as a rescue analgesic dose if visual analogue score was ≥ 3 or when patient suffering from pain between the assessment intervals in both groups not exceeding 0.1 mg/kg in a period of 6 hours. Metoclopramide 0.15 mg/kg IV will be prescribed for patients complaining of nausea or vomiting.

06

What researchers measure

Primary outcomes

  1. Intraoperative and postoperative Opiate consumption

    Intraoperative fentanyl and postoperative morphine consumption

    Time frame: Up to 24 hours

Secondary outcomes

  1. Time of the first postoperative analgesic request .

    Time of the first postoperative analgesic request (duration of the block).

    Time frame: Up to 24 hours

  2. Visual Analouge score

    Visual Analouge score score postoperative where 0=No Pain (better outcome) and 10=Intractable Pain (worse outcome)

    Time frame: Up to 24 hours

  3. Block onset

    Onset of the block

    Time frame: Up to 24 hours

07

Study locations

1 site
  • Ahmed Abdalla Mohamed
    Cairo, 11451, Egypt
08

References and documents

Individual participant data

Plan to share: Undecided — Still Working

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 4, 2020, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04110210
Lead sponsor
Cairo University
Responsible party
Ahmed Abdalla (Professor of Anesthesia &I.C.U and Pain Clinic, Cairo University, Cairo University) — Principal investigator
First posted
Oct 1, 2019
Start date
Sep 8, 2019
Primary completion
Jul 1, 2020
Completion
Jul 10, 2020
Last update
Aug 4, 2020

Study contacts

Ahmed Abdalla Mohamed, M.D
principal investigator · Cairo University

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Jul 2020. You cannot join it, but the record below documents what was studied.

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