Recruiting

Erector Spinae Plane BlockThe Erector Spinae Plane Block For Gastrointestinal Malignancy Pain Treatment (EGIPT)

Sponsor:

Abramson Cancer Center at Penn Medicine

Code:

NCT07211386

Conditions

Gastrointestinal Malignancy

Pain Control

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Interventions

Erector Spinae Plane Block

Study Details

Brief summary:

This study will target patients with gastrointestinal (GI) malignancy who present to any of 4 Penn Medicine emergency departments (EDs) with intractable abdominal pain. We will offer eligible patients an erector spinae plane block (ESPB), a regional anesthesia technique which is already offered to such patients in the ED at the University of Pennsylvania Healthy System (UPHS), for their intractable abdominal pain. We will compare the outcomes of this prospective cohort of patients to a matched historical control of patients with GI malignancy who were treated in the ED during the same time period as recruitment, but who were not recruited to partake in the study and who were managed with standard of care. Opioid consumption as measured by total milligram morphine equivalents (MMEs) over a 24-hour period and hospital length of stay (LOS) will be compared between cohorts. Additionally, for the ESPB cohort, pain level pre/post ESPB, and functionality and satisfaction with pain management at 24 hours will also be examined.

Conditions

Gastrointestinal Malignancy

Pain Control

Study ID

NCT07211386

Start date

Dec 11, 2025

Status verified date

Nov, 2025

Completion date

Jun 15, 2027

Anticipated

Primary completion date

May 15, 2027

Anticipated

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Inclusion Criteria:

1. Patients age > 18 years old with GI malignancy presenting to a Penn Medicine ED with intractable abdominal pain.
2. Same-day or recent CT scan of the abdomen / pelvis which demonstrates that the patient's abdominal pain can be reasonably attributed to a malignant source.

Exclusion Criteria:

1. Allergy to ropivacaine or history of local anesthetic systemic toxicity.
2. Pregnancy
3. Incarcerated
4. Patients being admitted for serial abdominal examinations to determine their surgical course.
5. Altered mental status or inability for patient to consent for the procedure
6. Hemodynamic instability
7. Previously enrolled in the study

Study Design

Enrollment

25 participants

Anticipated

Intervention Model

Single group

Primary purpose

Treatment

Interventions and Outcome Measures

Arms

experimental: Treatment Arm -- Erector Spinae Plane Block

Patients with gastrointestinal malignancy and abdominal pain will receive the erector spinae plane block for their abdominal pain.

Interventions

Erector Spinae Plane Block

The abdominal viscera, from the stomach to midway through the sigmoid colon, derives its sensory innervation from afferent fibers that travel with, but are distinct from, the sympathetic nerve fibers from the 5th thoracic (T5) to the 2nd lumbar (L2) spinal levels (Moore et al). These fibers converge at the celiac plexus, located near the celiac artery and the aorta. From there, they bifurcate into the paravertebral sympathetic chain and subsequently ascend to the spinal cord and integrate into the central nervous system (Lohse et al). The celiac plexus block is an invasive procedure performed by an interventional anesthesiologist or palliative care specialist to lyse the celiac plexus and has been shown to reduce pain and opiate use in patients suffering from GI malignancy (Ashlock et al). While there are multiple methods to perform a celiac plexus block, it involves a steep needle trajectory either posteriorly through the retroperitoneum or anteriorly through the abdominal wall close

Primary outcome measure

Opioid Consumption [ Time Frame: 24 hours ]
Opioid Consumption [ Time Frame: 24 hours ]

Central Contacts and Locations

Central contacts

Umar Aulia, AB

267-624-4394 umar.aulia@pennmedicine.upenn.edu

Michael Shalaby, MD

267-624-4394 michael.shalaby@pennmedicine.upenn.edu

Locations

Hospital of the University of Pennsylvania

Recruiting

Philadelphia, Pennsylvania, United States, 19104

Contacts

Umar Aulia, AB

267-624-4394 umar.aulia@pennmedicine.upenn.edu

Penn Presbyterian Medical Center

Recruiting

Philadelphia, Pennsylvania, United States, 19104

Contacts

Umar Aulia, AB

267-624-4394 umar.aulia@pennmedicine.upenn.edu

Pennsylvania Hospital

Recruiting

Philadelphia, Pennsylvania, United States, 19107

Contacts

Umar Aulia, AB

267-624-4394 umar.aulia@pennmedicine.upenn.edu

Hospital of the University of Pennsylvania -- Cedar Avenue

Recruiting

Philadelphia, Pennsylvania, United States, 19143

Contacts

Umar Aulia, AB

267-624-4394 umar.aulia@pennmedicine.upenn.edu

More Information

Sponsor

Abramson Cancer Center at Penn Medicine

Last update posted

Nov 28, 2025

Last verified

Nov, 2025

Keywords

Gastrointestinal malignancy
pain control
nerve block

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-08. This information was provided to ClinicalTrials.gov by Abramson Cancer Center at Penn Medicine on 2025-11-28.