Transversus Abdominis Plane Block for Laparoscopic Hysterectomy

NCT ID: NCT01552148

Last Updated: 2014-02-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

52 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-03-31

Study Completion Date

2013-03-31

Brief Summary

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Purpose To evaluate whether adding a transversus abdominis plane block in patients undergoing elective laparoscopic hysterectomy reduces Patient-controlled analgesia (PCA) morphine requirements during the first 24 hours postoperatively.

Forty-six patients undergoing laparoscopic hysterectomy will be randomized into two groups:

1. Group treatment TAP (n=23) will receive the following analgesia:

* US guided transversus abdominis plane block performed with 40ml of 0.375% levobupivacaine (20 ml per side) after general anaesthesia induction, before surgical start
* Morphine PCA with loading dose i.v. titrated by the PACU nurse if pain \> 5/10 at rest
2. Group control will receive:

* Morphine PCA with loading dose i.v. titrated by the PACU nurse if pain \> 5/10 at rest

Primary Outcome Measures:

Morphine consumption (mg) (Time Frame: 24 hours) in Groups TAP and Control

Secondary Outcome Measures:

* Pain at rest and during movement quantified as Numerical Rating Scores (0-10) for pain when resting in bed and during cough during the first 24 hours postoperatively
* Time to PACU dimission, evaluated as patient's achievement of a White's score \> or = 12/14
* Time to home discharge, evaluated as patient's achievement of a PADDS score \> or = 9
* Functional patient capacity as measured before surgery and whenever a White's score \> or = 12 will be reached (2minute walking test)
* Eventual side effects such as nausea/vomiting

Detailed Description

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After the start of the study, we had a higher drop out size than expected. We therefore added a 13% of patient to initial power calculation to compensate for drop outs.

Total number of patients enrolled = 52 (46 + 6) Total number of patients who completed the study = 44

Conditions

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Hysterectomy Laparoscopic Surgery

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Investigators

Study Groups

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Group TAP (US guided)

23 patients receiving bilateral US guided transversus abdominis plane block with 20ml of 0.375% levobupivacaine on each side, under general anaesthesia (TIVA), after induction and before surgical start

Group Type ACTIVE_COMPARATOR

USguided bilateral TAP block

Intervention Type OTHER

23 patients receiving bilateral US guided transversus abdominis plane block with 20ml of 0.375% levobupivacaine on each side, under general anaesthesia (TIVA), after induction and before surgical start

Morphine Patient Controlled Analgesia

Intervention Type DRUG

Morphine PCA i.v. (bolus 2mg, lockout 8 min)

Group Control

Group Type OTHER

Morphine Patient Controlled Analgesia

Intervention Type DRUG

Morphine PCA i.v. (bolus 2mg, lockout 8min)

Interventions

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USguided bilateral TAP block

23 patients receiving bilateral US guided transversus abdominis plane block with 20ml of 0.375% levobupivacaine on each side, under general anaesthesia (TIVA), after induction and before surgical start

Intervention Type OTHER

Morphine Patient Controlled Analgesia

Morphine PCA i.v. (bolus 2mg, lockout 8 min)

Intervention Type DRUG

Morphine Patient Controlled Analgesia

Morphine PCA i.v. (bolus 2mg, lockout 8min)

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* 18 years \< age \< 70 years
* ASA I - II - III
* undergoing elective laparoscopic hysterectomy
* signed informed consent

Exclusion Criteria

* chronic therapy with opioids/ antidepressants
* surgical conversion to open abdominal hysterectomy
* urgent/emergent surgery
* postoperative transfer to the intensive care unit
* pregnancy or breast feeding
* known allergy to any drug medication
* local skin infection
* epilepsy
* high bilirubin level (\> 3mg/dl) or high hepatic enzymes levels (\> 250UI)
* high creatinin level (\> 1.4mg/dl)
* 18Kg/m2 \< BMI \< 30Kg/m2
* alcohol or drug abuse
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Istituti Ospitalieri di Cremona

OTHER

Sponsor Role lead

Responsible Party

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Giorgio Danelli

Chief of the Anaesthesia Department, Istituti Ospitalieri, Cremona

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Azienda Ospedaliera Istituti Ospitalieri di Cremona

Cremona, CR, Italy

Site Status

Countries

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Italy

Other Identifiers

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5504/2012LD

Identifier Type: -

Identifier Source: org_study_id

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