Comparing Two Ultrasound-Guided Nerve Blocks to Improve Breathing After Liver Surgery

What this Trial Is About

Researchers are evaluating respiratory recovery after liver surgery using several measurable methods such as lung ultrasound, diaphragm movement, oxygen needs, and postoperative pulmonary complications. The study compares two types of nerve blocks, the erector spinae plane ESP block and the external oblique intercostal plane EOIP block, to see which better supports breathing recovery after open liver surgery. The study also examines whether better pain control contributes to improved breathing. Participants receive either the ultrasound-guided bilateral ESP block or the EOIP block after general anesthesia but before the surgical incision. Both blocks use 20 mL of 0.25% bupivacaine injected on each side in specific fascial planes, with ultrasound guidance to ensure accuracy. The EOIP block targets nerves between the external oblique and intercostal muscles, while the ESP block targets the plane beneath the erector spinae muscle. Both blocks are designed to provide pain relief after upper abdominal surgery. During the study, participants will be monitored at baseline and at several time points up to 24 hours after surgery to measure diaphragm movement, pain intensity at rest and during breathing or coughing, opioid use, oxygen requirements, lung ultrasound scores, and early pulmonary complications. These assessments help evaluate respiratory function and pain control. The total study period extends until the completion date in early 2027, with randomized assignment and quadruple masking to ensure unbiased results.

Comparative Effects of ESP Block and EOIP Block on Postoperative Respiratory Recovery Following Liver Resection