Efficacy of Adding Intrathecal Morphine to Erector Spinae Plane Block for Postoperative Analgesia After Midline Laparotomy

Condition(s) studied

Investigational drug(s) / intervention(s)

Intrathecal Morphine: Administration of a single-shot intrathecal injection containing hyperbaric bupivacaine combined with preservative-free morphine (ITM) during spinal anesthesia prior to the surgical incision."

Erector Spinae Plane Block: Bilateral ultrasound-guided erector spinae plane block performed at the T8-T10 level using a local anesthetic solution (such as bupivacaine or ropivacaine) injected deep to the erector spinae muscle fascia for postoperative abdominal analgesia.

Study summary

This study evaluates whether combining two distinct pain-relief techniques-a peripheral nerve block called the Erector Spinae Plane Block (ESPB) and a low-dose spinal medication injection called Intrathecal Morphine (ITM)-provides better postoperative pain management for adult patients undergoing major midline abdominal surgery (laparotomy) compared to using either technique alone. The main goal is to see if this combination improves pain control and reduces the total amount of opioids required by patients within the first 48 hours after surgery.

Eligibility

Primary outcome measure(s)

• Time to First Rescue Analgesia — Up to 48 hours postoperatively.
  Duration of time (in minutes/hours) elapsed from PACU admission to the patient's first request for an IV morphine rescue bolus.
• Postoperative Pain Intensity — At rest and during a standardized cough at 0, 2, 4, 6, 12, 24, and 48 hours postoperatively.
  Numeric Rating Scale (NRS) score ranging from 0 (no pain) to 10 (worst imaginable pain).
• Cumulative Opioid Consumption — Up to 48 hours postoperatively.
  Total postoperative intravenous rescue morphine consumed, calculated and recorded in Morphine Milligram Equivalents (MME).

Trial sites (1)

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