Postoperative PainNCT07654556
Investigating the Analgesic Efficacy and Ease of Perfomance of Modified Throracoabdominal Plane Block and Comparing it With Erector Spinea Plane Block in Laparacopic Sleeve Gasterctomy Surgeries
A study testing Bupivacaine 0.25% (isobaric) and Bupivaciane 0.25% (Isobaric) in people with Postoperative Pain, run by Cairo University.
Trial summary
Interest in surgical weight loss interventions continues to rise in the face of what has been dubbed the obesity epidemic. The most popular of these weight loss interventions is laparoscopic sleeve gastrectomy, which has proven to reduce morbidity and mortality of morbidly obese patients. Read more about this study
- Who is it for?
- Ages 18 to 60 years
- Conditions the study is for
- Postoperative Pain
- What is being tested?
- Bupivacaine 0.25% (isobaric) and Bupivaciane 0.25% (Isobaric)
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 64 participants
- Where
- No sites listed yet
- Study dates
- 1 Jul 2026to 30 Mar 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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 60 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Patients from both sexes.
- 18 to 60 years old.
- ASA physical status II-III scheduled for laparoscopic sleeve gastrectomy.
- Patients with BMI (40-50) kg/ m2
Who cannot join
- Patient Refusal
- Lack of patient cooperation.
- Patients with any contraindication to regional nerve blocks as coagulopathy or infection at site of injection
- Patients with anatomical abnormalities at site of injection
- Patients with known hypersensitivity to bupivacaine, or any of the used drugs.
- Patients with pre-existing neurological disorder
- Patients with chronic pain syndromes including fibromyalgia, complex regional pain syndrome (CRPS), or chronic pain requiring long-term opioid or neuropathic pain medications.
- Patients with history of long-acting opioids, steroids, anticonvulsants perioperatively.
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
Official title: Evaluating Analgesic Efficacy and Feasibility of Modified Thoracoabdominal Plane Block Compared With Erector Spinae Plane Block in Laparoscopic Sleeve Gastrectomy: A Randomized Controlled Study
Interest in surgical weight loss interventions continues to rise in the face of what has been dubbed the obesity epidemic. The most popular of these weight loss interventions is laparoscopic sleeve gastrectomy, which has proven to reduce morbidity and mortality of morbidly obese patients. The aim of effective perioperative pain management extends beyond increased patient comfort and includes reduced recumbency period, enhanced recovery, reduced hospital stay, and lowers postoperative complication rates.
Effective postoperative pain management has traditionally relied on multimodal strategies that combine systemic opioids, non-opioid medications, and regional anesthesia. Despite their efficacy, opioids are associated with a range of undesirable effects, such as nausea, vomiting, sedation, pruritus, and respiratory depression, which may impede early mobilization and recovery. These concerns have accelerated the adoption of ultrasound-guided regional anesthesia techniques as part of Enhanced Recovery After Surgery (ERAS) protocols, delivering superior pain control with fewer systemic adverse effects.
Read the detailed description
Among the newer regional techniques described for thoracoabdominal analgesia are the Modified thoracoabdominal plane block through perichondrial approach (M-TAPA) block and the erector spinae plane (ESP) block. The visceral analgesic effect of ESPB appears inconsistent and may be limited by technical and anatomical factors. ESPB requires relatively deep needle placement at thoracic levels, and achieving reliable anterior spread of local anesthetic is highly operator dependent. These challenges may be exacerbated in obese patients undergoing bariatric surgery, in whom ultrasound visualization and needle control can be technically demanding. Furthermore, uncertainty regarding the mechanism and extent of visceral afferent blockade, along with concerns about potential complications related to deep paraspinal injection, may limit the reproducibility and routine clinical applicability of ESPB in this population.
In contrast, the modified thoracoabdominal nerve block through the perichondrial approach (M-TAPA) is a more superficial and anatomically predictable technique designed to block thoracoabdominal nerves supplying the upper abdominal wall. Emerging evidence suggests that M-TAPA provides effective postoperative analgesia and opioid-sparing benefits in upper abdominal laparoscopic surgery, with a simpler and potentially safer technical profile compared with deeper regional techniques. Given its reduced operator dependency and technical simplicity, M-TAPA may represent an appealing alternative for patients undergoing laparoscopic sleeve gastrectomy. However, direct comparative evidence between ESPB and M-TAPA in this specific surgical context, particularly with respect to visceral pain control, remains lacking. Therefore, a randomized comparison of these two techniques is warranted.
- Conditions
- Postoperative Pain
- Being tested
- Bupivacaine 0.25% (isobaric), Bupivaciane 0.25% (Isobaric)
- Medical subject headings
- Pain, Postoperative
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Bupivacaine 0.25% (isobaric)Drug
A bilateral injection of 25 ml of 0.25% bupivacaine will be injected as a part of ultrasound guided M-TAPA block.
Bupivaciane 0.25% (Isobaric)Drug
A bilateral injection of 25 ml of 0.25% bupivacaine will be injected as a part of ultrasound guided ESP block.
| Study group | Role | What they receive |
|---|---|---|
| Modified thoracoabdominal plane block through perichondrial approach (M-TAPA) | Active comparator | The M-TAPA block will be performed after induction of general anaethesia, with total volume of 25ml of 0.25% bupivacaine. Receives: Drug: Bupivacaine 0.25% (isobaric) |
| Erector Spinea plane block (ESP block) | Active comparator | The ESP block will be performed after induction of general anaethesia , with total volume of 40 ml of 0.25% bupivacaine. Receives: Drug: Bupivaciane 0.25% (Isobaric) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Postoperative Visual Analogue Score
Measurment of postoperative Visual Analogue Score, which is a scale from 0 to 10 in which 0 indicates no pain while 10 denotes unbearable pain, this will be done after 48 hours.
Measured: 48 hours
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 Jun 2026
- Study start1 Jul 2026 (estimated)
- Primary completion30 Mar 2027 (estimated)
- Study completion30 Mar 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Postoperative PainStudies of the same condition, open and under way.
- More trials run by Cairo UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 N/A
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Participant, Care provider, Outcomes assessor
- Enrolment
- 64 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Fadi Nessim Guirguis, Cairo University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07654556
- Sponsor's protocol ID
- MD-79-2026
- Status last verified
- Jun 2026
- First submitted
- 13 Jun 2026
- Last updated
- 18 Jun 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 18 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Evaluating Analgesic Efficacy and Feasibility of Modified Thoracoabdominal Plane Block Compared With Erector Spinae Plane Block in Laparoscopic Sleeve Gastrectomy: A Randomized Controlled Study
- ClinicalTrials.gov ID
- NCT07654556
- Acronym / sponsor ID
- MD-79-2026
- Conditions
- Postoperative Pain
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 64 participants (estimated)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- 1 Jul 2026 (estimated)
- Primary completion
- 30 Mar 2027 (estimated)
- Study completion
- 30 Mar 2027 (estimated)
- First posted
- 17 Jun 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Interest in surgical weight loss interventions continues to rise in the face of what has been dubbed the obesity epidemic. The most popular of these weight loss interventions is laparoscopic sleeve gastrectomy, which has proven to reduce morbidity and mortality of morbidly obese patients. The aim of effective perioperative pain management extends beyond increased patient comfort and includes reduced recumbency period, enhanced recovery, reduced hospital stay, and lowers postoperative complication rates.
Effective postoperative pain management has traditionally relied on multimodal strategies that combine systemic opioids, non-opioid medications, and regional anesthesia. Despite their efficacy, opioids are associated with a range of undesirable effects, such as nausea, vomiting, sedation, pruritus, and respiratory depression, which may impede early mobilization and recovery. These concerns have accelerated the adoption of ultrasound-guided regional anesthesia techniques as part of Enhanced Recovery After Surgery (ERAS) protocols, delivering superior pain control with fewer systemic adverse effects.
Detailed description
Among the newer regional techniques described for thoracoabdominal analgesia are the Modified thoracoabdominal plane block through perichondrial approach (M-TAPA) block and the erector spinae plane (ESP) block. The visceral analgesic effect of ESPB appears inconsistent and may be limited by technical and anatomical factors. ESPB requires relatively deep needle placement at thoracic levels, and achieving reliable anterior spread of local anesthetic is highly operator dependent. These challenges may be exacerbated in obese patients undergoing bariatric surgery, in whom ultrasound visualization and needle control can be technically demanding. Furthermore, uncertainty regarding the mechanism and extent of visceral afferent blockade, along with concerns about potential complications related to deep paraspinal injection, may limit the reproducibility and routine clinical applicability of ESPB in this population.
In contrast, the modified thoracoabdominal nerve block through the perichondrial approach (M-TAPA) is a more superficial and anatomically predictable technique designed to block thoracoabdominal nerves supplying the upper abdominal wall. Emerging evidence suggests that M-TAPA provides effective postoperative analgesia and opioid-sparing benefits in upper abdominal laparoscopic surgery, with a simpler and potentially safer technical profile compared with deeper regional techniques. Given its reduced operator dependency and technical simplicity, M-TAPA may represent an appealing alternative for patients undergoing laparoscopic sleeve gastrectomy. However, direct comparative evidence between ESPB and M-TAPA in this specific surgical context, particularly with respect to visceral pain control, remains lacking. Therefore, a randomized comparison of these two techniques is warranted.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, care provider, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Modified thoracoabdominal plane block through perichondrial approach (M-TAPA) | Active comparator | Drug: Bupivacaine 0.25% (isobaric)The M-TAPA block will be performed after induction of general anaethesia, with total volume of 25ml of 0.25% bupivacaine. |
| Erector Spinea plane block (ESP block) | Active comparator | Drug: Bupivaciane 0.25% (Isobaric)The ESP block will be performed after induction of general anaethesia , with total volume of 40 ml of 0.25% bupivacaine. |
Who may qualify
- Ages
- 18 to 60 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (4 listed)
- Patients from both sexes.
- 18 to 60 years old.
- ASA physical status II-III scheduled for laparoscopic sleeve gastrectomy.
- Patients with BMI (40-50) kg/ m2
Key exclusion criteria (8 listed)
- Patient Refusal
- Lack of patient cooperation.
- Patients with any contraindication to regional nerve blocks as coagulopathy or infection at site of injection
- Patients with anatomical abnormalities at site of injection
- Patients with known hypersensitivity to bupivacaine, or any of the used drugs.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Bupivacaine 0.25% (isobaric)A bilateral injection of 25 ml of 0.25% bupivacaine will be injected as a part of ultrasound guided M-TAPA block. | Drug | Modified thoracoabdominal plane block through perichondrial approach (M-TAPA) |
| Bupivaciane 0.25% (Isobaric)A bilateral injection of 25 ml of 0.25% bupivacaine will be injected as a part of ultrasound guided ESP block. | Drug | Erector Spinea plane block (ESP block) |
Primary outcome
Postoperative Visual Analogue Score
Time frame: 48 hours
Measurment of postoperative Visual Analogue Score, which is a scale from 0 to 10 in which 0 indicates no pain while 10 denotes unbearable pain, this will be done after 48 hours.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 Jun 2026.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Questions about this trial
What is this clinical trial studying?
A study testing Bupivacaine 0.25% (isobaric) and Bupivaciane 0.25% (Isobaric) in people with Postoperative Pain, run by Cairo University.
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 4 inclusion and 8 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: opening soon, as of the sponsor's last update on 18 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.
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.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Hesham khedr Prof. Dr., Professor (01001622640 ext. 02, hkhishamkhedr@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Postoperative Visual Analogue Score (time frame: 48 hours). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 18 Jun 2026.