Abdominal nerve block versus thoracic epidural for pain after major abdominal cancer surgery
Safety and Efficacy of Combined Subcostal and Lateral Transversus Abdominis Plane Block for Postoperative Analgesia Versus Thoracic Epidural Analgesia in Patients Undergoing Major Abdominal Cancer Surgery
This will test whether combined subcostal and lateral transversus abdominis plane (TAP) blocks provide pain relief comparable to thoracic epidural anesthesia for adults having major abdominal cancer surgery.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 50 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Assiut University Academic / other |
| Locations | 1 site (Asyut) |
| Trial ID | NCT07273136 on ClinicalTrials.gov |
What this trial studies
Adults scheduled for major abdominal cancer operations at Assiut University will receive either combined subcostal and lateral TAP blocks or thoracic epidural anesthesia for postoperative pain control. Pain scores, opioid consumption, recovery markers such as return of bowel function and pulmonary outcomes, and adverse events will be recorded after surgery. The trial compares the safety and efficacy of the two regional anesthesia approaches within perioperative care and enhanced recovery pathways. Procedures will be performed by anesthesiologists experienced in regional techniques and patients will be followed during the immediate postoperative period.
Who should consider this trial
Good fit: Adults aged 18 or older with ASA physical status I–III who are scheduled for major abdominal cancer surgery and have no contraindications to regional anesthesia are ideal candidates.
Not a fit: Patients with coagulopathy, infection at the injection site, morbid obesity, chronic opioid use, pregnancy, or unstable intraoperative hemodynamics are unlikely to benefit or be eligible.
Why it matters
Potential benefit: If successful, TAP blocks could offer similar pain relief with fewer side effects and simpler management than thoracic epidurals, potentially speeding recovery.
How similar studies have performed: TAP blocks have been shown in other studies to reduce opioid use and support enhanced recovery, but direct comparisons with thoracic epidurals are limited and results have been mixed.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Age ≥ 18 years. * Both sexes. * American Society of Anesthesiologists (ASA) physical status I-III. * Scheduled for major abdominal surgeries including: (e.g., gastrectomy, colectomy, hepatectomy, cystectomy, total abdominal hysterectomy, Nephrectomy, pancreatectomy). Exclusion Criteria: * Intraoperative hemodynamic instability. * History or evidence of coagulopathy. * Infection or abdominal wall masses at injection site. * Morbid obesity. * Other Medical conditions including mental illness or substance abuse. * Known allergy to local anesthetics. * Chronic opioid use or chronic pain conditions. * Pregnancy.
Where this trial is running
Asyut
- Assiut University — Asyut, Egypt (Recruiting)
Study contacts
- Study coordinator: Bahaa G Saad, MD
- Email: bahaagamal@aun.edu.eg
- Phone: 00201555590977
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.