[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100598188":3},{"organization":4,"armGroups":7,"interventions":19,"overallOfficials":25,"centralContacts":26,"locations":25,"responsibleParty":36,"collaborators":25,"id":38,"slug":39,"hasResults":40,"nctId":41,"briefTitle":42,"officialTitle":43,"acronym":44,"eligibilityCriteria":45,"healthyVolunteers":46,"sex":47,"minAge":48,"maxAge":25,"enrollmentInfo":49,"targetDuration":25,"studyType":52,"phases":53,"briefSummary":55,"conditions":56,"keywords":59,"overallStatus":64,"whyStopped":25,"lastUpdateSubmitDate":65,"lastUpdatePostDateStruct":66,"startDateStruct":69,"completionDateStruct":71,"leadSponsor":73,"locationsCount":25},{"fullName":5,"class":6},"Duke University","OTHER",[8,14],{"label":9,"type":10,"description":11,"interventionNames":12},"Transverse Approach to the Rectus Sheath Block","ACTIVE_COMPARATOR","In the transverse approach, the US probe will be positioned perpendicular to the he rectus abdominis muscle's fibers, and the needle will be inserted in-plane from lateral to medial.",[13],"Drug: 1.0% lidocaine with epinephrine (1:100,000)",{"label":15,"type":16,"description":17,"interventionNames":18},"Longitudinal Approach to the Rectus Sheath Block","EXPERIMENTAL","In contrast, the longitudinal approach will involve aligning the probe parallel to the rectus muscle fibers, with the needle advanced in-plane from cephalad to caudad.",[13],[20],{"type":21,"name":22,"description":23,"armGroupLabels":24,"otherNames":25},"DRUG","1.0% lidocaine with epinephrine (1:100,000)","The block will be performed by advancing the needle into the posterior rectus sheath compartment, with the local anesthetic deposited posterior to the rectus abdominis muscle and anterior to the posterior rectus sheath.\n\nDrug: 20 mL injection of 1.0% lidocaine with epinephrine (1:100,000) on each side (40mL total\u002Fsubject)",[15,9],null,[27,32],{"name":28,"role":29,"phone":30,"phoneExt":25,"email":31},"David MacLeod, MBBS","CONTACT","9198123201","david.macleod@duke.edu",{"name":33,"role":29,"phone":34,"phoneExt":25,"email":35},"Sara Amaral, MD","7373479570","sara.amaral@duke.edu",{"type":37,"investigatorFullName":25,"investigatorTitle":25,"investigatorAffiliation":25,"oldNameTitle":25,"oldOrganization":25},"SPONSOR","100598188","phase-2-rectus-sheath-trial-100598188",false,"NCT07068243","REctus Sheath Trial","Transverse Versus Longitudinal Approaches for Rectus Sheath Block: a Randomized Controlled Trial in Healthy Volunteers","REST","Inclusion criteria:\n\n1. Ability to provide written informed consent\n2. Ability and willingness to comply with the study procedures and duration requirements\n3. ASA physical status 1 or 2\n4. Age ≥ 18 years\n5. Weight \\> 60kg\n\nExclusion criteria:\n\n1. BMI \\> 40kg.m-2\n2. Use of analgesics within 24 hours before the procedure\n3. History of abdominal trauma or surgery\n4. Abdominal deformities or abnormalities that may prevent proper block performance\n5. Abdominal tattoos in the supraumbilical area\n6. Systemic neuromuscular disease\n7. Contraindications to regional anesthesia (e.g., infection, allergy)\n8. Structures are unable to be visualized by ultrasound\n9. Pregnancy\n10. Other known health conditions that would affect the participant's ability to successfully complete the study",true,"ALL","18 Years",{"count":50,"type":51},25,"ESTIMATED","INTERVENTIONAL",[54],"PHASE2","Regional anesthesia techniques (or nerve blocks) are used to provide sensory blockade over the abdominal wall. The most established technique is thoracic epidural. This provides bilateral spread but is also associated with neuraxial complications, which has led to a decrease in clinical usage. The rectus sheath block (RSB) is an established regional anesthesia technique used to provide somatic analgesia to the midline anterior abdominal wall by depositing local anesthetic in the posterior rectus sheath, thereby targeting the terminal anterior branches of the lower thoracic intercostal nerves. The conventional approach involves placing the ultrasound (US) probe transversely across the rectus abdominis muscle and advancing the needle in-plane either lateral-to-medial or medial-to-lateral. While this technique achieves spread within the sheath, the cephalocaudal distribution of local anesthetic may be suboptimal, potentially limiting the extent of dermatomal coverage. A longitudinal probe orientation, with needle insertion from cephalad to caudad, may theoretically facilitate a more extensive cranio-caudal spread by aligning the injection axis with the anatomical fascial plane of the posterior rectus sheath. However, the relative efficacy of these two approaches has not been investigated in a controlled, comparative setting. Thus, this randomized, single-blinded trial aims to evaluate the dermatomal sensory distribution and ultrasound-assessed local anesthetic spread achieved by the transverse versus longitudinal in-plane approaches to ultrasound-guided RSB in healthy adult volunteers. To compare the dermatomal sensory block distribution, investigators will use dermatomal mapping with pinprick, and cold.",[57,58],"Acute Pain","Postoperative Pain, Acute",[60,61,62,63],"Rectus Sheath Block","Abdominal Block","Fascial Plane Block","RSB","NOT_YET_RECRUITING","2026-06-16",{"date":67,"type":68},"2026-06-17","ACTUAL",{"date":70,"type":51},"2026-09",{"date":72,"type":51},"2027-04",{"name":5,"class":6}]