Transversus Abdominis Plane Blocks With Abdominoplasty

Phase 4

• Conditions: Post Operative Pain
• Interventions: Drug: Ropivacaine 0.25%, 0.5 ml/kg

• Registration Number: NCT01278264
• Lead Sponsor: Clinique Saint-Jean, Bruxelles

Brief Summary

Comparing morphine consumption and recovery with two different TAP block techniques after abdominoplasty.

Detailed Description

TAP blocks have the potential to become an important part of multi-modal analgesia after abdominal surgery (1,2). Originally Dr J McDonnell described a blind double pop technique, trough the triangle of Petit, with up to 48 hours of analgesia (3,4). Dr P Hebbard described an ultrasound based technique with a subcostal (for supra-umbilical analgesia) and an axillary mid-line injection (for sub-umbilical analgesia) in the TAP, with reported analgesia for up to 8 hours (5,6). Recently Dr J McDonnell presented data showing para vertebral spread (up to L5) of the (high dose, low concentration) local anaesthetic explaining the prolonged analgesic effect (7,8). In 2007 Dr Blanco described an ultrasound guided technique for the posterior infiltration as performed by McDonnell (9). Our limited observational comparison between both block techniques confirms this difference. We decided to compare both techniques (the ultrasound guided single shot subcostal injection, the aTAP-group (Hebbard is from Australia) and the ultrasound guided posterior injection, the iTAP-group (McDonnell is from Ireland). We will use the same volume and concentration of local anesthetic and we will asses their analgesic efficacy and improvement in quality of recovery.

Study Timeline

• Study First Submitted: 2011-01-14
• Study First Submitted QC: 2011-01-14
• Study First Posted: 2011-01-17
• Status Verified: 2011-02
• Last Update Submitted: 2011-04-26
• Last Update Posted: 2011-04-27
• Study Start: 2011-06
• Primary Completion: 2012-05
• Study Completion: 2012-08

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: Female
• Target Recruitment: 60

Inclusion Criteria

• Eligible for abdominoplasty
• ASA 1-2
• Fluent french/dutch/english

Exclusion Criteria

• History of allergy to local anaesthetics
• Chronic opioids abuse
• Pregnant patients

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: FACTORIAL

Arm && Interventions

Group	Intervention	Description
iTAP-group	Ropivacaine 0.25%, 0.5 ml/kg	Posterior approach for TAP: ultrasound guided bilateral needle insertion in the transversus abdominis plane, anterior to the quadratus lumborum muscle
aTAP-group	Ropivacaine 0.25%, 0.5 ml/kg	Subcostal approach for TAP: US guided needle insertion in the transversus abdominis plane, lateral to rectus sheet

Primary Outcome Measures

Name	Time	Method
Morphine consumption	48 hours	Consumption measured by the use of the PCA pump

Secondary Outcome Measures

Name	Time	Method
VAS score	48 hours
Post operative nausea and vomiting	48 hours
Constipation	48 hours
Pruritus	48 hours
First time to get up	48 hours
First time to eat	48 hours

Trial Locations

Locations (1)

Clinique Saint Jean; 🇧🇪 Bruxelles, Belgium