Ultrasound-guided retro-SCTL versus external oblique intercostal plane block for pain after sleeve gastrectomy

Efficacy of Ultrasound-guided Retro Superior Costotransverse Ligament Space Block Versus External Oblique Intercostal Plane Block for Postoperative Analgesia in Laparoscopic Sleeve Gastrectomy: A Prospective Randomized Study

This will test whether two ultrasound-guided nerve blocks — retro superior costotransverse ligament (retro-SCTL) and external oblique intercostal plane (EOI) block — reduce opioid use and pain in adults with BMI >40 having laparoscopic sleeve gastrectomy.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 90 (estimated)
• Ages: 18 Years to 65 Years
• Sex: All
• Sponsor: Beni-Suef University (other)
• Locations: 1 site (Banī Suwayf, Beni Suweif Governorate)
• Trial ID: NCT07311525 on ClinicalTrials.gov

What this trial studies

Adults aged 18–65 with BMI >40 undergoing laparoscopic sleeve gastrectomy at Beni‑Suef University Hospital will receive either an ultrasound-guided retro-SCTL space block or an ultrasound-guided external oblique intercostal plane (EOI) block in addition to standard care. The primary outcome is total opioid consumption within 24 hours after surgery, with secondary outcomes including pain scores, opioid-related side effects, time to ambulation, and length of hospital stay. Blocks are performed under ultrasound guidance in the perioperative period and postoperative analgesic use is recorded and compared. This single-center interventional comparison aims to determine if one block provides better analgesia and fewer opioid complications than the other.

Who should consider this trial

Good fit: Adults 18–65 years old with BMI >40 kg/m2, ASA physical status I–II, scheduled for laparoscopic sleeve gastrectomy and without contraindications to regional anesthesia are ideal candidates.

Not a fit: Patients with endocrine causes of obesity, serious systemic organ dysfunction, coagulation disorders, chronic pain, current use of analgesic or psychotropic drugs, infection at the injection site, or those who convert to open surgery may not benefit or be ineligible.

Why it matters

Potential benefit: If one technique lowers opioid need and pain, patients could recover faster with fewer opioid-related breathing, sedation, and gastrointestinal side effects.

How similar studies have performed: Other abdominal wall and plane blocks have reduced postoperative opioid use in bariatric and abdominal surgery, but the retro-SCTL approach is relatively new and has limited published evidence compared with more established blocks.

Eligibility criteria

Inclusion Criteria:

* Patients aged between 18 to 65 years
* Both genders
* American Society of Anesthesiologists (ASA) physical status I-II
* Body mass index (BMI) \> 40 kg m-2,

Exclusion Criteria:

* Obesity secondary to an endocrine disorder
* known allergic diathesis to any drugs used in the study
* Presence of serious systemic illness (e.g., severe cardiac, pulmonary, renal, or hepatic dysfunction),
* Coagulation dysfunction
* Pre-existing psychological disorders
* Current use of analgesic or psychotropic medications
* Infection at a potential injection site
* Ahistory of chronic pain
* Conversion to laparotomy.

Where this trial is running

Banī Suwayf, Beni Suweif Governorate

• Beni-Suef University hospital — Banī Suwayf, Beni Suweif Governorate, Egypt (RECRUITING)

Study contacts

• Principal investigator: Dina M Fakhry, MD — Beni-Suef University
• Study coordinator: Dina M Fakhry, MD

Conditions: Patient Satisfaction, Sleeve Gastrectomy, Postoperative Analgesia, External Oblique Intercostal Plane Block, Retro superior costotransverse ligament space block