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SurgeryPhase 1/2NCT05257941

ESP Block VS Intrathecal Opioid After Laparoscopic Colorectal Surgery

A Phase 1/2 study testing IT Injection and ESP Block in people with Surgery, run by Indiana University at 1 site in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

This study is being done to compare 2 types of pain control methods and determine which is more effective postoperatively for laparoscopic colorectal surgery. Group 1 will receive an intrathecal (IT) injection in the back in which a small dose duramorph and bupivacaine will be placed into the spinal fluid. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Surgery
What is being tested?
IT Injection and ESP Block
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
116 participants
Where
1 siteUnited States
Study dates
27 Jan 2022to 29 Aug 2024
Phase
Phase 1/2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients undergoing an elective laparoscopic colorectal procedure at Indiana University Hospital or Methodist Hospital
  • ASA Class 1, 2, 3 (American Society of Anesthesiologists physical status classification system)
  • Age 18 to 80 years (male or female)
  • BMI < 40kg/m2
  • Desires regional anesthesia for postoperative pain control

Who cannot join

  • Any contraindication for neuraxial analgesia or ESP block procedure
  • Contraindications for neuraxial analgesia include: Elevated intracranial pressure (except in cases of pseudo-tumor cerebri), infection at the site of injection, lack of consent from the patient, patient refusal, true allergy to any drug used in the spine, and uncorrected hypovolemia.
  • Contraindications for ESP block procedure include: Infection at the site of injection, patient refusal, true allergy to any of the drugs used in the block, and lack of patient consent.
  • Any patient undergoing a laparoscopic abdominoperineal resection.
  • Any physical, mental or medical conditions which, in the opinion of the investigators, may confound quantifying postoperative pain resulting from surgery.
  • Known true allergy to the study medications (morphine, bupivacaine, decadron, Tylenol, Celebrex)
Show all 10Show fewer
  • Takes over 30 mg of oral morphine equivalents daily
  • Any history of substance abuse in the past 6 months
  • End stage liver disease, end stage renal disease
  • Body weight of < 50 kg

Trial locations and contacts

1 site in 1 country.

United States1 site
  • IU Health University Hospital

    Indianapolis, Indiana, 46202

Other trials in United States

About this study

Official title: Randomized Prospective Study Comparison of Erector Spinae Plane Block and Intrathecal Opioid for Postoperative Analgesia After Laparoscopic Colorectal Surgery in an Enhanced Recovery Setting

This study is being done to compare 2 types of pain control methods and determine which is more effective postoperatively for laparoscopic colorectal surgery. Group 1 will receive an intrathecal (IT) injection in the back in which a small dose duramorph and bupivacaine will be placed into the spinal fluid. Group 2 will receive an erector spinae plane (ESP) block in which bupivacaine and decadron are injected near the nerves under a muscle in the back.

Read the detailed description

All laparoscopic colorectal cases were scheduled by colorectal surgeons at IU Health University or Methodist Hospital and were identified using medical records. The subjects were contacted face-to-face prior to surgery. They were informed about the study and questions were answered. The potential subjects were given a copy of the informed consent form and authorization form. The subjects were contacted face-to-face in Pre-Operative Care Unit on the day of surgery and if they decided to participate, written consent was taken.

In the Intrathecal group, intrathecal preservative free morphine (duramorph) 200 mcg with 7.5mg of hyperbaric bupivacaine was given for a patient 18-75 years of age and duramorph 150 mcg with 7.5mg of hyperbaric bupivacaine was given for a patient 76- 80 years of age.

In the ESP group, a patient was given a bilateral ESP block at thoracic vertebrae level 10 (T10). This was placed under ultrasound using 30 ml of 0.25% bupivacaine and 4 mg of Decadron.

Randomization will be performed using Research Randomizer. The primary investigator informed the person doing the regional techniques as to what group the patients were randomized to. Neither the patients and the research staff doing assessments will be blinded to the randomization.

Conditions
Surgery
Being tested
IT Injection, ESP Block

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • IT InjectionDrug

    Also called Intrathecal (IT)

    an intrathecal (IT) injection in the back in which a small dose duramorph and bupivacaine will be placed into the spinal fluid

  • ESP BlockDrug

    Also called Erector Spinae Plane Block (ESP)

    an erector spinae plane (ESP) block in which bupivacaine and decadron are injected near the nerves under a muscle in the back

Study groups in NCT05257941
Study groupRoleWhat they receive
IT InjectionActive comparatoran intrathecal (IT) injection in the back in which a small dose duramorph and bupivacaine will be placed into the spinal fluid
Receives: Drug: IT Injection
ESP BlockActive comparatoran erector spinae plane (ESP) block in which bupivacaine and decadron are injected near the nerves under a muscle in the back.
Receives: Drug: ESP Block

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. 24 Hour Cumulated Oral Morphine Equivalent (OME)

    24 hour cumulated oral morphine consumption (OME)

    Measured: 24 hours after surgery

Secondary outcomes (19)
  1. Oral Morphine Equivalents (OME)

    Oral Morphine Equivalents consumed

    Measured: 1 hour after surgery

  2. Oral Morphine Equivalents (OME)

    Oral Morphine Equivalent consumption

    Measured: 12 hours after surgery

  3. Oral Morphine Equivalents (OME)

    Oral Morphine Equivalent consumption

    Measured: 24 hours after surgery

  4. Oral Morphine Equivalents (OME)

    Oral Morphine Equivalent consumption

    Measured: 48 hours after surgery

  5. Oral Morphine Equivalents (OME)

    Oral Morphine Equivalent Consumption

    Measured: 72 hours after surgery

  6. Visual Analog Scale Pain Scores

    pain scores using the Visual Analog Scale (0-10 with 0 being no pain and 10 being the worst pain)

    Measured: 1 hour after surgery

  7. Visual Analog Scale Pain Scores

    pain scores using the Visual Analog Scale (0-10 with 0 being no pain and 10 being the worst pain)

    Measured: 12 hours after surgery

  8. Visual Analog Scale Pain Scores

    pain scores using the Visual Analog Scale (0-10 with 0 being no pain and 10 being the worst pain)

    Measured: 24 hours after surgery

  9. Visual Analog Scale Pain Scores

    pain scores using the Visual Analog Scale (0-10 with 0 being no pain and 10 being the worst pain)

    Measured: 48 hours after surgery

  10. Visual Analog Scale Pain Scores

    pain scores using the Visual Analog Scale (0-10 with 0 being no pain and 10 being the worst pain)

    Measured: 72 hours after surgery

  11. First Ambulation

    Time to patient first ambulation

    Measured: Duration of hospital stay up to 72 hours

  12. First Flatus

    Time to first flatus

    Measured: Duration of hospital stay up to 72 hours

  13. Oral Liquid

    Time to first oral liquid intake

    Measured: Duration of hospital stay up to 72 hours

  14. Oral Food

    Time to first oral food intake

    Measured: Duration of hospital stay up to 72 hours

  15. Hospital Length of Stay

    Amount of time each subject spends in the hospital before discharge

    Measured: Duration of hospital stay up to 7 days

  16. Patient's Satisfaction Scores

    Assess patient's satisfaction with care (1-10 with 1 being the least satisfied and 10 being the most satisfied)

    Measured: 24 hours after surgery

  17. Patient's Satisfaction Scores

    Assess patient's satisfaction with care (1-10 with 1 being the least satisfied and 10 being the most satisfied)

    Measured: 48 hours after surgery

  18. Number of Participants With Side Effects

    Incidence of urinary retention, ileus, spinal headache, pruritis, respiratory depression, injection site infection, nerve damage, hematoma, pneumothorax, lower extremity weakness.

    Measured: Duration of hospital stay up to 72 hours

  19. Nausea

    point in time of which had nausea

    Measured: Duration of hospital stay up to 72 hours

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Feb 2022
  2. Study start27 Jan 2022
  3. Primary completion26 Aug 2024
  4. Study completion29 Aug 2024

Why it stopped: study specific patients are now scheduled at another hospital for this procedure

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
116 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05257941
Sponsor's protocol ID
12514
Status last verified
Feb 2026
First submitted
25 Jan 2022
Last updated
2 Mar 2026
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Kehlet H, Wilmore DW. Evidence-based surgical care and the evolution of fast-track surgery. Ann Surg. 2008 Aug;248(2):189-98. doi: 10.1097/SLA.0b013e31817f2c1a.

    PubMed 18650627
  • Ljungqvist O, Scott M, Fearon KC. Enhanced Recovery After Surgery: A Review. JAMA Surg. 2017 Mar 1;152(3):292-298. doi: 10.1001/jamasurg.2016.4952.

    PubMed 28097305
  • Miller TE, Thacker JK, White WD, Mantyh C, Migaly J, Jin J, Roche AM, Eisenstein EL, Edwards R, Anstrom KJ, Moon RE, Gan TJ; Enhanced Recovery Study Group. Reduced length of hospital stay in colorectal surgery after implementation of an enhanced recovery protocol. Anesth Analg. 2014 May;118(5):1052-61. doi: 10.1213/ANE.0000000000000206.

    PubMed 24781574
  • Wind J, Polle SW, Fung Kon Jin PH, Dejong CH, von Meyenfeldt MF, Ubbink DT, Gouma DJ, Bemelman WA; Laparoscopy and/or Fast Track Multimodal Management Versus Standard Care (LAFA) Study Group; Enhanced Recovery after Surgery (ERAS) Group. Systematic review of enhanced recovery programmes in colonic surgery. Br J Surg. 2006 Jul;93(7):800-9. doi: 10.1002/bjs.5384.

    PubMed 16775831
  • Lassen K, Soop M, Nygren J, Cox PB, Hendry PO, Spies C, von Meyenfeldt MF, Fearon KC, Revhaug A, Norderval S, Ljungqvist O, Lobo DN, Dejong CH; Enhanced Recovery After Surgery (ERAS) Group. Consensus review of optimal perioperative care in colorectal surgery: Enhanced Recovery After Surgery (ERAS) Group recommendations. Arch Surg. 2009 Oct;144(10):961-9. doi: 10.1001/archsurg.2009.170.

    PubMed 19841366
  • Khoo CK, Vickery CJ, Forsyth N, Vinall NS, Eyre-Brook IA. A prospective randomized controlled trial of multimodal perioperative management protocol in patients undergoing elective colorectal resection for cancer. Ann Surg. 2007 Jun;245(6):867-72. doi: 10.1097/01.sla.0000259219.08209.36.

    PubMed 17522511
  • McEvoy MD, Scott MJ, Gordon DB, Grant SA, Thacker JKM, Wu CL, Gan TJ, Mythen MG, Shaw AD, Miller TE; Perioperative Quality Initiative (POQI) I Workgroup. American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on optimal analgesia within an enhanced recovery pathway for colorectal surgery: part 1-from the preoperative period to PACU. Perioper Med (Lond). 2017 Apr 13;6:8. doi: 10.1186/s13741-017-0064-5. eCollection 2017.

    PubMed 28413629
  • Marret E, Remy C, Bonnet F; Postoperative Pain Forum Group. Meta-analysis of epidural analgesia versus parenteral opioid analgesia after colorectal surgery. Br J Surg. 2007 Jun;94(6):665-73. doi: 10.1002/bjs.5825.

    PubMed 17514701
  • Borzellino G, Francis NK, Chapuis O, Krastinova E, Dyevre V, Genna M. Role of Epidural Analgesia within an ERAS Program after Laparoscopic Colorectal Surgery: A Review and Meta-Analysis of Randomised Controlled Studies. Surg Res Pract. 2016;2016:7543684. doi: 10.1155/2016/7543684. Epub 2016 Aug 24.

    PubMed 27642630
  • Liu H, Hu X, Duan X, Wu J. Thoracic epidural analgesia (TEA) vs. patient controlled analgesia (PCA) in laparoscopic colectomy: a meta-analysis. Hepatogastroenterology. 2014 Jul-Aug;61(133):1213-9.

    PubMed 25436285
  • Merchea A, Lovely JK, Jacob AK, Colibaseanu DT, Kelley SR, Mathis KL, Spears GM, Huebner M, Larson DW. Efficacy and Outcomes of Intrathecal Analgesia as Part of an Enhanced Recovery Pathway in Colon and Rectal Surgical Patients. Surg Res Pract. 2018 Mar 1;2018:8174579. doi: 10.1155/2018/8174579. eCollection 2018.

    PubMed 29687077
  • Koning MV, Klimek M, Rijs K, Stolker RJ, Heesen MA. Intrathecal hydrophilic opioids for abdominal surgery: a meta-analysis, meta-regression, and trial sequential analysis. Br J Anaesth. 2020 Sep;125(3):358-372. doi: 10.1016/j.bja.2020.05.061. Epub 2020 Jul 11.

    PubMed 32660719
  • Day AR, Smith RV, Scott MJ, Fawcett WJ, Rockall TA. Randomized clinical trial investigating the stress response from two different methods of analgesia after laparoscopic colorectal surgery. Br J Surg. 2015 Nov;102(12):1473-9. doi: 10.1002/bjs.9936. Epub 2015 Sep 23.

    PubMed 26395762
  • Levy BF, Scott MJ, Fawcett W, Fry C, Rockall TA. Randomized clinical trial of epidural, spinal or patient-controlled analgesia for patients undergoing laparoscopic colorectal surgery. Br J Surg. 2011 Aug;98(8):1068-78. doi: 10.1002/bjs.7545. Epub 2011 May 17.

    PubMed 21590762
  • Pedrazzani C, Menestrina N, Moro M, Brazzo G, Mantovani G, Polati E, Guglielmi A. Local wound infiltration plus transversus abdominis plane (TAP) block versus local wound infiltration in laparoscopic colorectal surgery and ERAS program. Surg Endosc. 2016 Nov;30(11):5117-5125. doi: 10.1007/s00464-016-4862-5. Epub 2016 Mar 22.

    PubMed 27005290

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing IT Injection and ESP Block in people with Surgery, run by Indiana University at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 2 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 2 Mar 2026). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

24 Hour Cumulated Oral Morphine Equivalent (OME) (time frame: 24 hours after surgery). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05257941, which also lists 40 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Mar 2026.

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