Transversus Abdominis Plane and Rectus Sheath Block for Robotic Colectomy
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: Ropivacaine, Saline.
- Who it may be relevant to
- Registry conditions: Rectus Sheath Block, Transversus Abdominis Plane Block, Enhanced Recovery After Surgery, Robotic Surgery. Basic parameters: 20 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
- Taiwan
- 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
Impact of Transversus Abdominis Plane Block Combined With Rectus Sheath Block on Postoperative Pain Management in Patients Undergoing Elective Robotic Colectomy
Overview
This study aimed to evaluate the impact of ultrasound-guided bilateral transversus abdominis plane block combined with rectus sheath block on postoperative pain and recovery after robotic colectomy under an enhanced recovery after surgery (ERAS) protocol.
Detailed description
Postoperative pain remains an important concern after robotic colectomy despite the implementation of enhanced recovery after surgery (ERAS) protocols. Although robotic colectomy is associated with smaller incisions and faster recovery than conventional open surgery, postoperative pain may still impair early ambulation, gastrointestinal recovery, and patient satisfaction. Multimodal analgesia strategies, including acetaminophen and nonsteroidal anti-inflammatory drugs, are commonly used in ERAS pathways to reduce opioid consumption and opioid-related adverse effects. However, postoperative pain during movement and opioid requirements remain clinically relevant issues.
Ultrasound-guided transversus abdominis plane (TAP) block has been reported to reduce postoperative pain and opioid consumption after colorectal surgery. In addition, rectus sheath block (RSB) may provide further analgesic benefit for midline abdominal incision pain. Nevertheless, the additional clinical benefit of combining TAP block and RSB in patients undergoing robotic colectomy within an established ERAS pathway has not been fully investigated.
This study aimed to evaluate the impact of ultrasound-guided bilateral TAP block combined with RSB on postoperative pain and recovery following robotic colectomy. Additionally, we investigated the influence of TAP block combined with RSB on postoperative opioid consumption, postoperative nausea and vomiting, early ambulation, gastrointestinal recovery, and length of hospital stay after robotic colectomy under ERAS management.
Interventions
- Drug Ropivacaine
TAP+RS block using ropivacaine - Drug Saline
TAP+RS block with saline
Primary outcome measures
- Visual Analogue Scale at Resting [Time frame: Postoperative 48 hours]
- Visual Analogue Scale at Movement [Time frame: Postoperative 48 hours]
- Postoperative Opioid Consumption [Time frame: Postoperative 48 hours]
Secondary outcome measures (4)
- Postoperative Adverse Event [Time frame: From surgery until hospital discharge]
- Time to First Ambulation [Time frame: From surgery until hospital discharge]
- Time to First Flatus [Time frame: From surgery until hospital discharge]
- Hospital Stay [Time frame: At hospital discharge]
Eligibility criteria
Inclusion criteria
- Patients scheduled for elective robotic colorectal cancer surgery for the first time
Exclusion criteria
- Age < 18 years or age > 80 years
- Allergic to any medication in the protocol
- Infection over the injection site
- Chronic pain history
- Severe hepatic or renal insufficiency
- Pregnancy
- Emergency surgery
- Refusal to join the study
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
Taiwan · 1 center
- Tri-Service General Hospital — Taipei
Publications
- Yang R, Wang J, Shi DW, Niu Y, Zhou XD, Liu Y, Xu GH. The Efficiency of Multipoint Rectus Sheath Block Based on Incision Location in Laparoscopic-Assisted Colorectal Surgery: A Randomized Clinical Trial. Dis Colon Rectum. 2023 Dec 1;66(12):1578-1586. doi: 10.1097/DCR.0000000000002895. Epub 2023 Jun 28. PMID 37379171
- Liu KY, Lu YJ, Lin YC, Wei PL, Kang YN. Transversus abdominis plane block for laparoscopic colorectal surgery: A meta-analysis of randomised controlled trials. Int J Surg. 2022 Aug;104:106825. doi: 10.1016/j.ijsu.2022.106825. Epub 2022 Aug 8. PMID 35953018
- Viderman D, Aubakirova M, Abdildin YG. Transversus Abdominis Plane Block in Colorectal Surgery: A Meta-Analysis. Front Med (Lausanne). 2022 Feb 23;8:802039. doi: 10.3389/fmed.2021.802039. eCollection 2021. PMID 35295183
- Liu L, Xie YH, Zhang W, Chai XQ. Effect of Transversus Abdominis Plane Block on Postoperative Pain after Colorectal Surgery: A Meta-Analysis of Randomized Controlled Trials. Med Princ Pract. 2018;27(2):158-165. doi: 10.1159/000487323. Epub 2018 Feb 1. PMID 29402875
- Hain E, Maggiori L, Prost A la Denise J, Panis Y. Transversus abdominis plane (TAP) block in laparoscopic colorectal surgery improves postoperative pain management: a meta-analysis. Colorectal Dis. 2018 Apr;20(4):279-287. doi: 10.1111/codi.14037. PMID 29381824
Identifiers
NCT: NCT07624916 · C202605053