Recruiting

EOIFP vs. OSTAP

Sponsor:

The Cleveland Clinic

Code:

NCT06409156

Conditions

Open Abdominal Surgery

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Interventions

Oblique Subcostal Transversus Abdominis Plane Block

External Oblique Intercostal Fascial Plane block

Study Details

Brief summary:

The investigators propose a single-center, assessor blinded, randomized control trial to compare the efficacy of external oblique fascial plane (EOIFP) block versus Oblique Subcostal Transversus Abdominis Plane (OSTAP) block for patients undergoing open upper abdominal surgery at Cleveland Clinic Main Campus.

Conditions

Open Abdominal Surgery

Study ID

NCT06409156

Start date

Jun 26, 2024

Status verified date

Mar, 2026

Completion date

Dec 31, 2026

Anticipated

Primary completion date

Dec 31, 2026

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Inclusion Criteria:

  • Written informed consent;
  • 18-85 years old;
  • ASA Physical Status 1-3
  • Scheduled for elective open upper abdominal surgery with supraumbilical incision (gastrectomy, hepatectomy, pancreatectomy, splenectomy, supraumbilical ventral hernia repair).
  • Anticipated hospitalization of three nights;
  • Expected requirement for parenteral opioids for at least 48 hours for postoperative pain

Exclusion Criteria:

  • Hepatic disease, e.g. twice the normal levels of liver enzymes;
  • Chronic kidney disease according to GFR (may be stage 3 or worse as defined by a GFR <60
  • Allergic reaction to study medications;
  • Women who are pregnant or breastfeeding;
  • Nephrectomy or lower abdominal surgeries such as hysterectomy, colorectal surgeries
  • Patient refusal

Study Design

Enrollment

100 participants

Anticipated

Allocation

Randomized

Intervention Model

Parallel Assignment

Primary purpose

Prevention

Interventions and Outcome Measures

Arms

active comparator: Oblique Subcostal Transversus Abdominis Plane Block

Researchers will perform the Oblique Subcostal Transversus Abdominis Plane Block using sterile technique under ultrasound guidance. Once the target is visualized, a 20-gauge, 4-inch echogenic needle will be advanced in-plane to the fascial plane. 5 ml of 0.9% normal saline will be injected through the needle to open the fascial plane and then a single dose (10 ml) of liposomal bupivacaine mixed with 20 mL of bupivacaine 0.25% will be injected on each side.

experimental: External Oblique Intercostal Fascial Plane block

Researchers will perform the External Oblique Intercostal Fascial Plane block using sterile technique under ultrasound guidance. Once the target is visualized, a 20-gauge, 4-inch echogenic needle will be advanced in-plane to the fascial plane. 5 ml of 0.9% normal saline will be injected through the needle to open the fascial plane and then a single dose (10 ml) of liposomal bupivacaine mixed with 20 mL of bupivacaine 0.25% will be injected on each side.

Interventions

Oblique Subcostal Transversus Abdominis Plane Block

With the OSTAP block, local anesthetic is injected into the fascial plane between the posterior rectus sheath and the transversus abdominis muscle beneath the subcostal margin.

External Oblique Intercostal Fascial Plane block

With the EOIF block, local anesthetic targets the terminal part of the thoracoabdominal nerves pass behind the costal cartilage and continue anteriorly in the plane between the internal oblique and transversus abdominis muscle, before piercing the rectus abdominis sheath as anterior cutaneous branches supplying the skin of the midabdomen.

Primary outcome measure

  • feasibility for the learning curve of EOIFP Vs OSTAP [ Time Frame: 3 days ]

Central Contacts and Locations

Central contacts

Fabio Rodriguez, MD

216-444-9950rodrigf3@ccf.org

Ehab Farag, MD

216 870-8719farage@ccf.org

Locations

Cleveland Clinic Foundation

Recruiting

Cleveland, Ohio, United States, 44195

Contacts

Ehab Farag, MD

farage@ccf.org

More Information

Sponsor

The Cleveland Clinic

Last update posted

Mar 18, 2026

Last verified

Mar, 2026

Keywords

  • Abdominal Block

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-10. This information was provided to ClinicalTrials.gov by The Cleveland Clinic on 2026-03-18.