Trans Abdominal Plane Block (TAP Block) in Surgery of Stoma Reversal and Its Effect on Post Operative Recovery: a Prospective, Randomized, Muticenter Study
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Surgery
- Sponsor
- University Hospital, Clermont-Ferrand
- Enrollment
- 149
- Locations
- 2
- Primary Endpoint
- Quo 40 score
- Status
- Completed
- Last Updated
- 3 years ago
Overview
Brief Summary
The primary purpose of TAPAS study is to demonstrate the superiority of analgesic effect of trans abdominal plane block (TAP block) performed at the beginning of stoma reversal, compared to standard of care.
The hypothesize is that a TAP block performed at the beginning of surgery of stoma reversal would improve patient's satisfaction (evaluated by Quo-r40 questionnaire), would reduce the incidence of post operative pain, time spent in recovery room, and reduce hospitalisation time
Detailed Description
The patient will arrive in the department the day before the surgical intervention (D-1). During this preoperative visit (D-1), the investigator * will preselect potentially eligible patients * will offer to participate to this study * will give the notice form to the patients * will present the research: objectives, benefits and constraints for the patients The intervention day (D0): The investigator will collect the signed consent form after having ascertained the understanding of the notice form by the patient and checking the inclusion and non-inclusion criteria. The randomization will be done via the eCRF module (allocation group and number) and the preoperative data registration in the eCRF. Surgical Intervention (D1): All patients will receive standard anaesthesia using sufentanyl, propopol, cisatracurium and sevoflurane. Prevention of nausea and vomiting is performing using Apfel score. Anti microbial prophylaxis is performed according recommendations. All patients will receive post operative multimodal analgesia using, acetaminophene, ketaminophene (if no contra indication), nefopam, and morphine if NRS (numerating rating scale) \> 3 At the end of the surgery, patients in the experimental group will receive a ultrasound guided trans abdominal plane block with 20 ml of 5 mg/mg of ropivacaine. Patients in the control group will not receive the block
Investigators
Eligibility Criteria
Inclusion Criteria
- •Age \> 18 years old
- •Patients operated of a scheduled stoma reversal surgery
- •Patients having given consent in the mannen described in Article L1122-1-1 of the Public Health Code
- •Patients affiliated with asocial security regimen or beneficiary of such a regimen
Exclusion Criteria
- •Renal insufficiency (ie glomerular filtration output \< 35 ml/min)
- •Patients with chronic inflammatory bowel disease
- •Body mass index \> 35 kg/m2
- •Chronic pain with opiates
- •Patients with cognitive troubles
- •Coagulation disorders (platelets count \< 80G/L, PT\< 50%, V factor \< 50%)
- •Pregnancy
- •Breastfeeding
- •Local anesthesics (amide class) allergy
Outcomes
Primary Outcomes
Quo 40 score
Time Frame: Day 1 (
Once the patient is transferred in post operative surgical service, assessment of the primary outcome will be done by the physician in charge of the patient. Quo 40 score is a postoperative recovery score above 200 points validated by Myles et al in 2001.
Secondary Outcomes
- Time spent in recovery room(At the output of recovery room ie until 6 hours after intervention)
- Quo 40 score(Day 15)
- NRS (Numeric rating scale)(Day 2)