Timing of Subcostal TAPB Combined With Rectus Sheath Block for Postoperative Pain After Laparoscopic Cholecystectomy
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Ultrasound-guided subcostal TAP block combined with rectus sheath block.
- Who it may be relevant to
- Registry conditions: Postoperative Pain, Laparoscopic Cholecystectomy. Basic parameters: 18 years — 80 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- South Korea
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Effect of Timing of Ultrasound-Guided Subcostal Transversus Abdominis Plane Block Combined With Rectus Sheath Block on Postoperative Pain in Laparoscopic Cholecystectomy: A Prospective Randomized Controlled Trial
Overview
This prospective randomized controlled trial aims to evaluate whether the timing of ultrasound-guided subcostal transversus abdominis plane (TAP) block combined with rectus sheath block (RSB) affects postoperative pain in patients undergoing laparoscopic cholecystectomy. Participants will be randomly assigned to receive the combined regional blocks either before surgical incision or after completion of surgery. The primary outcome is postoperative pain intensity measured using a numerical rating scale. Secondary outcomes include opioid consumption, incidence of postoperative nausea and vomiting, and other recovery parameters. The results of this study may help optimize the timing of abdominal wall blocks to improve postoperative analgesia and recovery following laparoscopic cholecystectomy.
Detailed description
Postoperative pain after laparoscopic cholecystectomy remains a significant clinical concern despite the minimally invasive nature of the procedure. Ultrasound-guided abdominal wall blocks, including subcostal transversus abdominis plane (TAP) block and rectus sheath block (RSB), are widely used to reduce postoperative pain and opioid requirements. However, the optimal timing of block administration relative to surgical incision remains unclear.
This prospective, single-center, randomized controlled trial will compare the analgesic efficacy of pre-incisional versus post-operative administration of combined ultrasound-guided subcostal TAP block and RSB in adult patients undergoing elective laparoscopic cholecystectomy under general anesthesia.
Participants will be randomized in a 1:1 ratio using block randomization with randomly permuted block sizes. Standardized general anesthesia and postoperative analgesia protocols will be applied to all participants.
The primary outcome will be postoperative pain intensity measured using a numerical rating scale at predefined time points after surgery. Secondary outcomes will include cumulative opioid consumption, incidence of postoperative nausea and vomiting, rescue analgesic requirements, and recovery profiles.
The findings of this study are expected to provide evidence for optimizing the timing of abdominal wall block administration to improve postoperative analgesia and patient recovery after laparoscopic cholecystectomy.
Interventions
- Procedure Ultrasound-guided subcostal TAP block combined with rectus sheath block
Ultrasound-guided right subcostal transversus abdominis plane (TAP) block combined with bilateral rectus sheath block (RSB) is performed under sterile conditions using local anesthetic for postoperative analgesia.
Primary outcome measures
- Maximum postoperative pain intensity within 24 hours [Time frame: Within 24 hours after surgery]
Secondary outcome measures (3)
- Maximum postoperative pain intensity during post-anesthesia care unit stay [Time frame: During the post-anesthesia care unit stay]
- Cumulative rescue opioid consumption within 24 hours [Time frame: Within 24 hours after surgery]
- Incidence of postoperative nausea and vomiting [Time frame: Within 24 hours after surgery]
Eligibility criteria
Inclusion criteria
- Elective laparoscopic cholecystectomy
- Adults aged 18 to 80 years
- Ability to understand the study procedures and provide informed consent
- American Society of Anesthesiologists (ASA) physical status I-III
Exclusion criteria
- Presence of significant pain unrelated to the target disease that may interfere with pain assessment
- Known allergy or contraindication to study medications (ropivacaine, acetaminophen, nefopam, or pethidine)
- Planned single-port laparoscopic cholecystectomy
- American Society of Anesthesiologists (ASA) physical status IV or higher
- Infection of the abdominal wall or skin at the injection site, or anatomical abnormalities of the abdominal wall
- Major neurological, psychiatric, or systemic diseases that may affect pain perception, treatment response, or study evaluation
- Requirement for postoperative mechanical ventilation
- Pregnancy or breastfeeding
- Considered unsuitable for the study by the investigator
- Refusal to participate or inability to provide informed consent
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Double blind
- Primary purpose
- Treatment
Study locations
South Korea · 1 center
- Nowon Eulji University Hospital — Seoul
Identifiers
NCT: NCT07440940 · 2026-01-026