Analgesic Efficacy of Intertransverse Process Block Versus Erector Spinae Plane Block

Condition(s) studied

Investigational drug(s) / intervention(s)

Intertransverse Process Block (ITP): Intertransverse Process Block (ITP) block will be performed 30 minutes prior to surgery with the patient in a sitting position. After skin disinfection with chlorhexidine, the skin and subcutaneous tissues will be anesthetized using 2-4 mL of 1% lidocaine. A linear ultrasound probe will be positioned along the medial border of spinous processs level of the 10th thoracic vertebrae. Anatomical landmarks, including the erector spinae muscle, transverse processes, and superior costotransverse ligament complex at the T10 level, will be identified. Upon confirmation and negative aspiration, 20 mL of 0.25% bupivacaine hydrochloride will be administered on each side under ultrasound guidance.

The Erector Spinae Plane Block (ESP): The Erector Spinae Plane Block (ESP) will be performed 30 minutes prior to surgery with the patient in a sitting position. After skin disinfection with chlorhexidine, the skin and subcutaneous tissues will be anesthetized using 2-4 mL of 1% lidocaine. A linear ultrasound probe will be positioned along the medial border of spinous processs level of the 10th thoracic vertebrae. Anatomical landmarks, including the trapezius muscle, rhomboid major muscle (RMM), erector spinal muscle and transverse processes of the 10th thoracic vertebrae will be identified. Proper needle placement will be confirmed with the injection of 1-2 mL isotonic saline. Upon confirmation and negative aspiration, 20 mL of 0.25% bupivacaine hydrochloride will be administered.

Study summary

This randomized clinical trial aims to evaluate and compare the analgesic efficacy of the Intertransverse Process Block (ITP) and the Erector Spinae Plane (ESP) block in patients undergoing Robotic Colorectal Surgery. The primary outcome is the Visual Analog Scale (VAS) score within the first 24 hours after surgery. Secondary outcomes include total opioid consumption, requirement for rescue analgesia, block-related and systemic side effects (hematoma, pneumothorax, local anesthetic systemic complications, vascular puncture, and infection), patient and surgeon satisfaction assessed using a Likert scale, and quality of recovery assessed using the QoR-15 questionnaire, and incedence of postoperative nausea and vomiting.

Eligibility

Primary outcome measure(s)

• postoperative pain intensity (VAS score) — 0, 1, 4, 8, 12, and 24 hours after surgery
  Postoperative pain will be assessed using the visual analog scale (VAS), ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores represent greater pain intensity. Measurements will be recorded at predefined time points within the first 24 hours after surgery.

Trial sites (1)

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