Pain Control After Open Radical Nephrectomy: Thoracic Paravertebral Block Versus External Oblique Intercostal Block

NCT07071012 — Not applicable, Completed, 98 participants, Hacettepe University

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Ultrasound-Guided Thoracic Paravertebral Block Versus External Oblique Intercostal Block for Postoperative Analgesia After Open Radical Nephrectomy: A Randomised Controlled Trial

Registry	NCT07071012
Status	Completed
Phase	Not applicable
Study type	Interventional; randomized, parallel, masking: single, treatment
Enrollment	98 (Actual)
Sponsor	Hacettepe University (Other)
Conditions	Nephrectomy, Pain Scores, Paravertebral Block, External Oblique Intercostal Block
Interventions	Bupivacaine, morphine, paracetamol, Diclofenac (Drug)
Dates	start 2025-08-01, primary completion 2026-02-01, completion 2026-02-02, first posted 2025-07-17, last updated 2026-03-17
Locations	1 site in Turkey (Türkiye)

-Summary

This study aims to compare the effects of external oblique intercostal block versus paravertebral block on postoperative pain and complications in patients undergoing open nephrectomy.

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+Arms and interventions

Arm	Type	Interventions	Description
Paravertebral block	Active comparator	Drug: Bupivacaine; Drug: morphine; Drug: paracetamol; Drug: Diclofenac	Patients scheduled to undergo thoracic paravertebral block will receive an injection of 20 ml of 0.25% bupivacaine hydrochloride into the paravertebral space between the parietal pleura and the costotransverse ligament using a block needle under ultrasound guidance.
External Oblique Intercostal Block	Active comparator	Drug: Bupivacaine; Drug: morphine; Drug: paracetamol; Drug: Diclofenac	Patients scheduled to undergo an external oblique intercostal block will receive an injection of 30 ml of 0.25% bupivacaine hydrochloride between the external oblique muscle and the intercostal muscle at the level of the 6th rib, using a block needle under ultrasound guidance.

Bupivacaine (Drug): Used for regional anesthesia during nephrectomy procedure (e.g., paravertebral or external oblique intercostal block)
morphine (Drug): Used for postoperative pain control via PCA device
paracetamol (Drug): Used as part of postoperative multimodal analgesia
Diclofenac (Drug): Used as part of postoperative multimodal analgesia

+Outcome measures

Primary outcomes

Postoperative Pain Score [Up to 24 hours after surgery]: Pain intensity measured using Visual Analog Scale at rest. (Visual Analog Scale ranging from 0 = no pain to 10 = worst pain imaginable; higher scores indicate worse pain).

+Eligibility

Sex: All, ages: 18 Years to 90 Years

Inclusion Criteria:

* Aged 18 to 90 years
* Scheduled for elective open radical nephrectomy for renal cell carcinoma
* ASA classification I-III
* Mini-Mental State Examination score ≥24
* Provided written informed consent

Exclusion Criteria:

* Neuropathy
* Hepatic failure
* Coagulopathy
* Local anesthetic allergy
* Mini-Mental State Examination score <24
* Refusal to participate

+Locations (1)

Facility	City	Country	Status
Hacettepe University Faculty of Medicine Hospital	Ankara	Turkey (Türkiye)