Comparing two ultrasound-guided nerve blocks for pain after open kidney removal

Analgesic Efficacy of Ultrasound-Guided Serratus Intercostal Plane Block Versus Erector Spinae Plane Block for Postoperative Pain Control After Open Nephrectomy: A Prospective Randomized Controlled Trial

We will test whether a serratus intercostal plane block or an erector spinae plane block provides better pain relief for adults having open nephrectomy.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 132 (estimated)
• Ages: 18 Years to 65 Years
• Sex: All
• Sponsor: Fayoum University Hospital (other)
• Locations: 1 site (Al Fayyum)
• Trial ID: NCT07556536 on ClinicalTrials.gov

What this trial studies

This is a double-blinded, randomized trial that will assign adults undergoing elective open nephrectomy to receive either a serratus intercostal plane block or an erector spinae plane block under ultrasound guidance after induction of general anesthesia. Group allocation is concealed and patients and outcome assessors are blinded, while the anesthesiologist who performs the block does not participate in postoperative assessments. All patients receive standardized general anesthesia, and blocks are performed before surgical incision with postoperative pain, opioid consumption, and complications recorded. The study follows local ethics approval and obtains written informed consent prior to randomization.

Who should consider this trial

Good fit: Adults aged 18–65 years with ASA physical status I–III who are scheduled for elective open nephrectomy via a flank incision are ideal candidates.

Not a fit: Patients on chronic opioid therapy, those with coagulation disorders, infection at the injection site, allergy to local anesthetics, or cognitive impairment affecting pain scoring are unlikely to benefit or be eligible.

Why it matters

Potential benefit: If successful, the trial could identify a block technique that provides better postoperative pain control, reduces opioid use, and speeds recovery after open nephrectomy.

How similar studies have performed: Erector spinae plane blocks have shown beneficial analgesia for various thoracic and abdominal surgeries in prior reports, while serratus-intercostal plane blocks are less well studied specifically for open nephrectomy.

Eligibility criteria

Inclusion Criteria:

1. Patients scheduled for elective open nephrectomy under general anesthesia via flank incision .
2. Adult patients aged 18-65 years.
3. Patients with an American Society of Anesthesiologists (ASA) physical status I to III.

Exclusion Criteria:

1. Patient refusal.
2. Allergy to local anesthetics and patient with infection at the injection site of block.
3. Coagulation disorders or ongoing anticoagulant therapy.
4. Patients receiving opioids for chronic analgesic therapy (cancer, addiction).
5. Cognitive impairment preventing pain scoring.
6. Neurological or psychiatric disorders affecting pain assessment.

Where this trial is running

Al Fayyum

• Fayoum university hospital — Al Fayyum, Egypt (RECRUITING)

Study contacts

• Principal investigator: Mohamed A Hamed, MD — faculty of medicine, fayoum university
• Study coordinator: Hasnaa M Hashem, Master

Conditions: Post Operative Pain, Open Nephrectomy, serratus intercostal plane block, Erector spinae plane block, open nephrectomy