IRCT20230204057318N9 IRCT 2025-07-19 Shahid Beheshti University of Medical Sciences Comparison of erector spinae and the subfascial-subcutaneous blocks Comparison analgesia of erector spinae plane block under ultrasound guidance and the combination of subfascial and subcutaneous ropivacaine blocks in open kidney donor nephrectomy surgery 2025-07-19 anticipated 105 Complete https://irct.ir/trial/82718 interventional Randomization: Randomized, Blinding: Double blinded, Placebo: Not used, Assignment: Parallel, Purpose: Treatment, Randomization description: For randomization, a simple randomization method will be used using Random Generator software. First, a set of random numbers will be generated, then eligible patients will receive a random number before anesthesia. Based on the assigned number, patients will be assigned to one of three study groups (numbers 1 to 35 were assigned to Group 1, numbers 36 to 70 to Group 2, and numbers 71 to 105 to Group 3), Blinding description: Participant information will be recorded and utilized exclusively using a numerical code to ensure that both their identity and the type of intervention remain unknown. Throughout all stages of data collection, outcome assessment, and statistical analysis, the research team members will only be exposed to these codes and will have no knowledge of the intervention type. (Allocation Concealment) Participants will be unaware of which treatment group they are in. Nevertheless, all treatment methods in the study will be explained to each participant at the beginning when obtaining consent, and the apparent procedures will be identical for all groups, as patients will be under anesthesia during the procedure and the blocks do not create any visual difference for observation. (Blinding) The clinical caregiver (surgeon and anesthesiologist) will only be aware of the type of intervention for the duration of its performance and will have no role in data collection or results analysis after the intervention. The individual responsible for data collection and outcome assessment will only have access to each person’s random code and will be unaware of the group allocation and the type of intervention participants received. The statistical analyst will conduct the data analysis with the coded data, without knowledge of the intervention type, to ensure the blinding process is maintained throughout the study. 3 Pain control after open nephrectomy in donors. Intervention 1: Intervention Group 1: Erector Spinae (ESPB) Group. After confirming landmarks and the correct injection site (T7–T9 vertebral levels, erector spinae muscle, transverse process), an ultrasound-guided in-plane technique will be performed using a 22G needle. The needle tip will be positioned on the transverse process of the vertebra. A local anesthetic (20 mL of 0.25% ropivacaine) will be injected. Intervention 2: Intervention Group 2: Surgeon-Administered Injection. At the end of the surgery, before closing the fascia, the surgeon (the same individual for all patients) will inject 10 milliliters of 0.25% ropivacaine subfascially and 10 milliliters of 0.25% ropivacaine subcutaneously at the incision site. Intervention 3: In the control group, patients will receive only morphine at a dose of 0.1 mg/kg for pain relief without receiving any nerve block. Undecided - It is not yet known if there will be a plan to make this available Justification or reason for indecision in sharing IPD is All data is potentially shareable after de-identifying individuals.