Analgesic Efficacy of Local Anesthetic Transversus Abdominis Plane (TAP) Blocks in Abdominal Surgery

Study Overview
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Brief Summary
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The aim of the study is to establish the efficacy of local anaesthetic TAP (transversus abdominis plane) blocks in providing pain relief in the first 24hrs following open or laparoscopic elective abdominal colorectal operations. TAP blocks involve the injection of local aesthetic (ropivicaine) into the transversus abdominis plane in the abdominal wall. This injection takes place after induction of anaesthesia, but before the commencement of surgery. TAP blocks have been proposed as a potential safer alternative to epidural anaesthesia. The blocks have been extensively used in the Hunter New England system over the last 18 months. As yet there is no clear evidence for there efficacy, hence the need for this trial. This trial would establish the efficacy of this practice. If the technique proves effective it could be widely used and provide a simpler method of managing post operative pain.

Official Title
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Efficacy of Local Anesthetic TAP Blocks in Providing Pain Relief Following Laparoscopic and Open Abdominal Surgery

Conditions
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Pain

Intervention / Treatment
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* Procedure: US-Guided Ropivacaine TAP Block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All patients aged 18 and over undergoing elective open or laparoscopic colorectal surgery performed by the participating surgeons within the study period will be considered for the trial. Exclusion Criteria: History of adverse reaction to Ropivicaine or similar drug. Inability or refusal to give consent Coagulopathic Severe renal impairment Aged <18 years

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: 1<br>Open Laparotomy Arm: All patients enrolled in the study who are undergoing elective open laparotomy surgery. | Procedure: US-Guided Ropivacaine TAP Block<br>* Bilateral injection of local anaesthetic into the Transversus Abdominis plane, guided by ultrasound.<br>* Other names: TAP Block;|
| Active Comparator: 2<br>Laparoscopic Arm: All patients enrolled in the study who are undergoing elective laparoscopic abdominal surgery. | Procedure: US-Guided Ropivacaine TAP Block<br>* Bilateral injection of local anaesthetic into the Transversus Abdominis plane, guided by ultrasound.<br>* Other names: TAP Block;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| mg/kg of morphine equivalent used by patients post operatively. |  | From operation until discharge. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Lung Function (spirometry), including FVC, FEV1 and PEFR |  | 24, 48 and 72 hours postoperatively | 
| Visual Analogue Scale for pain at rest, deep breathing and coughing. |  | 24, 48 and 72 hours postoperatively | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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postoperative analgesia, abdominal surgery, ropivacaine, local anaesthesia, tap block, pain management