Clinical trial NCT06382376: The Effect of Analgesia Methods Applied in Gynecological Cancer Surgeries on Postoperative Analgesia
Official title: Four-quadrant Transversus Abdominis Plane Block Versus Intrathecal Morphine in Gynecological Cancer Surgeries: a Single-center Retrospective Study.
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Gynecological Cancer Surgery
Regional Anesthesia Morbidity
Keywords: gynecological cancer surgery
periferal block
neuraxial block
Lead sponsor: Bakirkoy Dr. Sadi Konuk Research and Training Hospital
Sponsor class: OTHER_GOV
First posted: 2024-04-24
Enrollment: 71
Sex: FEMALE
Minimum age (years): 18
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Between June 1, 2023 and December 1, 2023, 71 patients over the age of 18 who underwent surgery for ASA II and III gynecological cancer, to whom we applied intrathecal morphine or four-quadrant transversus abdominis plane block (TAPB) from peripheral nerve blocks for postoperative analgesia, were included in the study.

Brief summary: The aim of this study is to compare the effectiveness of intrathecal morphine and four-quadrant transversus abdominis plane block applied for postoperative analgesia in gynecological cancer surgeries.

The key question(s) it aims to answer are:

\[Is intrathecal morphine more effective in postoperative analgesia?\] Patients who underwent gynecological cancer surgery were examined retrospectively. The investigators evaluated the effect of intrathecal morphine and four-quadrant transversus abdominis plane block applied for postoperative analgesia on pain scores and postoperative opioid use.

Detailed description: Our study was designed retrospectively. The investigators evaluated analgesia methods in patients who underwent laparoscopic or open surgery due to gynecological cancer between June 2023 and December 2023. The investigators evaluated the effect of intrathecal morphine and four-quadrant transversus abdominis plane block on postoperative analgesia and opioid use.

Group 1: Intrathecal morphine administered group Group 2: Four quadrant transversus abdominis plane block applied group

Eligibility criteria: Inclusion Criteria:

* 18 years

  * Patients who have undergone gynecological cancer surgery

Exclusion Criteria:

* \<18 years
* Those with missing data

Primary outcomes:
measure: postoperative numerical rating scale
timeFrame: 24 hours postoperatively
Secondary outcomes:
measure: postoperative opioid use
timeFrame: 24 hours postoperatively
Other outcomes:
Locations:
city: Istanbul
country: Turkey
facility: Başakşehir Çam and Sakura City Hospital
state: Basaksehir
Study officials:
affiliation: Başakşehir Çam & Sakura City Hospital
name: Duygu Akyol
role: PRINCIPAL_INVESTIGATOR
References:
citation: Black KA, Nelson G, Goucher N, Foley J, Pin S, Chong M, Ghosh S, Bisch SP. Effect of transversus abdominis plane block on postoperative outcomes in gynecologic oncology patients managed on an Enhanced Recovery After Surgery pathway. Gynecol Oncol. 2023 Nov;178:1-7. doi: 10.1016/j.ygyno.2023.09.003. Epub 2023 Sep 18.
citation: Niraj G, Kelkar A, Hart E, Kaushik V, Fleet D, Jameson J. Four quadrant transversus abdominis plane block and continuous transversus abdominis plane analgesia: a 3-year prospective audit in 124 patients. J Clin Anesth. 2015 Nov;27(7):579-84. doi: 10.1016/j.jclinane.2015.07.005. Epub 2015 Aug 28.
citation: Pirie K, Traer E, Finniss D, Myles PS, Riedel B. Current approaches to acute postoperative pain management after major abdominal surgery: a narrative review and future directions. Br J Anaesth. 2022 Sep;129(3):378-393. doi: 10.1016/j.bja.2022.05.029. Epub 2022 Jul 6.
citation: Meylan N, Elia N, Lysakowski C, Tramer MR. Benefit and risk of intrathecal morphine without local anaesthetic in patients undergoing major surgery: meta-analysis of randomized trials. Br J Anaesth. 2009 Feb;102(2):156-67. doi: 10.1093/bja/aen368.