Efficacy of Laparoscopic-assisted Transversus Abdominus Plane (TAP) Block Compared to Ultrasound-guided TAP Block in Minimally Invasive Gynecologic Surgeries: A Prospective, Randomized Control Trial. (TAP)

  • STATUS
    Recruiting
  • days left to enroll
    21
  • participants needed
    80
  • sponsor
    Yale University
Updated on 4 October 2022
Accepts healthy volunteers

Summary

We propose a clinical trial to determine the efficacy of Laparoscopic Transversus Abdominis Plane (LA-TAP) performed intraoperatively compared with usual postoperative analgesia without LA-TAP block. We hypothesise that there will be a decrease in postoperative opioid utilization and in pain scores for patients randomized to receive the LA-TAP block verses those who do not. We expect that patients will opt to take less break through opioid medication in the LA-TAP block group versus the no TAP block group.

Investigators aim to answer the above questions through the following primary and secondary

outcomes

Primary outcomes Is there a difference in pain scores reported by the patient at 24 hours following LA-TAP versus no TAP block? Is there a clinically significant difference in cumulative postoperative opioid consumption, expressed as milligram morphine equivalents (MMEs) at 24 hours following LA-TAP blocks versus no TAP block? Secondary outcomes Is there a difference between study groups in pain scores at 48 & 72 hours? Is there a difference between study groups in total opioid consumption (MMEs) by 48 & 72 hours? Is there a difference between the study groups for reported post-operative nausea and vomiting? Is there a difference between the study groups in operating time? Is there a difference between the study groups in the length of Hospital stay? Is there a difference between the study groups in patient's satisfaction?

Description

Investigators aim to answer the above questions through the following primary and secondary

outcomes

Primary outcomes Is there a difference in pain scores reported by the patient at 24 hours following LA-TAP versus no TAP block? Is there a clinically significant difference in cumulative postoperative opioid consumption, expressed as milligram morphine equivalents (MMEs) at 24 hours following LA-TAP blocks versus no TAP block? Secondary outcomes Is there a difference between study groups in pain scores at 48 & 72 hours? Is there a difference between study groups in total opioid consumption (MMEs) by 48 & 72 hours? Is there a difference between the study groups for reported post-operative nausea and vomiting? Is there a difference between the study groups in operating time? Is there a difference between the study groups in the length of Hospital stay? Is there a difference between the study groups in patient's satisfaction?

Patients will be randomized in two arms , LA-TAP , NO-TAP block . Each patient would fill out the pain score sheet and number of narcotic medications she used in first 24h, 48h and 72 h post operatively .

Details
Condition the Efficacy of Analgesia of Laparoscopic TAP Block in Minimally Invasive Gynecology Surgeries
Treatment TAP block with liposomal bupivacaine and bupivacaine
Clinical Study IdentifierNCT04345341
SponsorYale University
Last Modified on4 October 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

Patients 18 years old and above
English speaking
patients with capacity to consent
Elective laparoscopic and robotic benign genecology cases
Elective laparoscopy/ robotic hysterectomy
Elective laparoscopy/robotic myomectomy
ERAS (enhanced recovery after surgery) protocol applied

Exclusion Criteria

Pregnant women
patients with positive urine pregnancy test in pre operative
emergency procedures
Procedure requiring staging or debulking
surgeries that convert to laparotomy
patients with allergy to local/systemic anaesthesia or analgesia
Inability to undergo normal anesthesia induction process
ASA III or higher
history of pain relief medication dependence
history of substance abuse
end stage chronic kidney disease
advanced liver disease
history of chronic pain
history of taking opioids or neuropathic agents regularly prior to surgery
BMI of 50 or over
skin infections at the site of TAP block injection or port sites
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