Evaluating Combined Subcostal and Lateral Transversus Abdominis Plane Block Versus Thoracic Epidural Analgesia for Pain Control After Major Abdominal Cancer Surgery

What this Trial Is About

This research aims to evaluate the safety and effectiveness of a combined subcostal and lateral transversus abdominis plane TAP block compared with thoracic epidural anesthesia TEA for pain relief after major abdominal cancer surgery. Postoperative pain is commonly managed by various methods, with TEA traditionally considered the standard due to its reliable pain control and additional benefits like reduced intestinal blockage and better lung function. TAP blocks are increasingly important in pain management and recovery protocols following surgery. Participants will be randomly assigned to one of two groups one receiving an ultrasound-guided combined subcostal and lateral TAP block, and the other receiving an ultrasound-guided thoracic epidural anesthesia. Both methods involve precise ultrasound guidance to deliver anesthesia and are studied to compare their effects on postoperative pain control after major abdominal surgeries such as gastrectomy, colectomy, or hepatectomy. During the study, participants will be monitored for total morphine use within 24 hours after surgery, time to first need for additional pain relief, blood pressure and heart rate during surgery, level of pain after 24 hours, and any side effects occurring after surgery. The study includes double-blind procedures and random assignment, with follow-up assessments focused on safety and pain management outcomes. The trial is sponsored by Assiut University and will run until April 2026.

Combined Subcostal and Lateral Transversus Abdominis Plane Block for Postoperative Analgesia Versus Thoracic Epidural Analgesia in Patients Undergoing Major Abdominal Cancer Surgery