Ultrasound-guided EXORA (external oblique and rectus abdominis plane) block for pain and stress in umbilical hernia repair
The Effect of Ultrasound Guided External Oblique and Rectus Abdominis Plane Block (EXORA) on Neuroendocrine Stress Response in Adults Undergoing Umbilical Hernia Surgery: A Prospective Randomized Controlled Trial
This trial will test whether adding an ultrasound-guided EXORA block to general anesthesia reduces surgical stress hormones and postoperative pain after elective umbilical hernia repair in adults.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 100 (estimated) |
| Ages | 21 Years to 65 Years |
| Sex | All |
| Sponsor | Tanta University Academic / other |
| Locations | 1 site (Tanta) |
| Trial ID | NCT07324863 on ClinicalTrials.gov |
What this trial studies
Adults scheduled for elective umbilical hernia repair under general anesthesia will receive either standard general anesthesia alone or general anesthesia plus an ultrasound-guided external oblique and rectus abdominis plane (EXORA) block. Researchers will measure neuroendocrine stress markers and postoperative analgesia using hormonal assays and pain scoring at defined time points before and after surgery. The EXORA block is a fascial plane technique intended to numb the anterolateral abdominal wall and may complement or fill gaps left by other blocks such as QLB or ESP. Outcomes will include differences in hormonal stress response and measures of postoperative opioid requirement and pain control.
Who should consider this trial
Good fit: Ideal candidates are adults aged 21–65 years with ASA physical status I–II who are scheduled for elective umbilical hernia repair under general anesthesia.
Not a fit: Patients with ASA III–IV, metabolic disorders (like diabetes), those on corticosteroids, with coagulation problems, anatomical abnormalities, complicated/obstructed hernias, or allergy to local anesthetics are excluded and unlikely to benefit from this protocol.
Why it matters
Potential benefit: If successful, the EXORA block could reduce the hormonal stress response and postoperative pain, potentially lowering opioid needs and improving recovery after umbilical hernia repair.
How similar studies have performed: Other fascial plane blocks (e.g., TAP, QLB, ESP) have demonstrated postoperative analgesic benefit, but the EXORA block is an emerging technique with limited direct outcome data to date.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Aged from 21 to 65 years. * Both sexes. * American Society of Anesthesiologists (ASA) Physical status I and Ⅱ. * Schedule for elective umbilical hernia surgery under general anesthesia. Exclusion Criteria: * ASA Ⅲ or Ⅳ. * Patients with metabolic abnormalities, e.g., diabetes mellitus. * Patients receiving corticosteroids. * History of allergies to local anesthetics. * Bleeding or coagulation disorders. * Anatomical abnormalities. * Psychiatric and neurological disorders. * Complicated hernial defect (obstructed). * Patient refusal.
Where this trial is running
Tanta
- Tanta University — Tanta, Egypt (Recruiting)
Study contacts
- Study coordinator: Mayada H Sokeer, Master
- Email: mayada.hady@med.tanta.edu.eg
- Phone: 00201095315597
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.