Influence of Analgesic Technique on Post Operative Rehabilitation After Median Laparotomy

NCT ID: NCT04985695

Last Updated: 2025-12-16

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

RECRUITING

Clinical Phase

NA

Total Enrollment

110 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-10-11

Study Completion Date

2029-04-10

Brief Summary

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Randomized controlled trial (1:1) in two parallel groups, multicentric, open-label, comparing two locoregional anesthesia (LRA) techniques as integral parts of multimodal analgesia: the control group will benefit from epidural anesthesia, while the experimental group will benefit from bilateral placement of catheters in the sheath of the rectus abdominis muscles.

Detailed Description

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Implementation of fast-track rehabilitation surgery was essential in patient care, specially in oncological point.

In this way, uses of the technic of local anesthesia, include epidural analgesia, was essential, but this one is associated with few complications. Emergence of new technic of anesthesia with a comparative analgesia and without side effects should be a better alternative than epidural analgesia. Thus, bilateral rectus sheath block has been reported to be effective in management of postoperative pain.

After signing of the informed consent, two postoperative analgesia techniques were investigated in patients undergoing midline laparotomy.

The main objective of this study is to compare the influence of analgesic technique on the Quality of Recovery-15 score. The study design was a prospective, randomized trial with 2 parallel arms (epidural analgesia vs bilateral rectus sheath block).

Conditions

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Laparotomy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Thoracic epidural anesthesia

Epidural analgesia during midline laparotomy

Group Type ACTIVE_COMPARATOR

Epidural analgesia

Intervention Type DRUG

All patients received local anesthesia (3-5 ml of 2% Lidocaine). During the preoperative induction of anaesthesia a catheter was inserted 4cm into the epidural space. The catheter will be load during the intervention (0.1 ml/kg/h). In postoperative situation, a patient controlled epidural analgesia was introduced with a debit adapted to the arterial pressure.

Laparotomy

Intervention Type PROCEDURE

A midline sub or supra umbilical laparotomy or xypho-pubian laparotomy

Bilateral rectus sheath block

Bilateral rectus sheath block during midline laparotomy

Group Type EXPERIMENTAL

Bilateral rectus sheath block

Intervention Type DRUG

Bilateral rectus sheath block was performed Under general anesthesia and with ultrasound guidance. Rectus sheath block was inserted on each side of the abdomen. All patients received ropivacaine through elastomeric pump

Laparotomy

Intervention Type PROCEDURE

A midline sub or supra umbilical laparotomy or xypho-pubian laparotomy

Interventions

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Epidural analgesia

All patients received local anesthesia (3-5 ml of 2% Lidocaine). During the preoperative induction of anaesthesia a catheter was inserted 4cm into the epidural space. The catheter will be load during the intervention (0.1 ml/kg/h). In postoperative situation, a patient controlled epidural analgesia was introduced with a debit adapted to the arterial pressure.

Intervention Type DRUG

Bilateral rectus sheath block

Bilateral rectus sheath block was performed Under general anesthesia and with ultrasound guidance. Rectus sheath block was inserted on each side of the abdomen. All patients received ropivacaine through elastomeric pump

Intervention Type DRUG

Laparotomy

A midline sub or supra umbilical laparotomy or xypho-pubian laparotomy

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* ASA (American Society of Anesthesiologists) Class I-IV adult, with programmed midline laparotomy
* Have given an informed written consent
* Able to read and understand french language
* Affiliation to a social security system

Exclusion Criteria

* Local anesthesic contraindication (allergy, porphyria, haemolytic anaemia, uncontrolled epilepsy, or severe cardiac conduction disorders) or TEA (coagulation disorders, progressive neurological disease, or severe spinal disorder),
* Epidural analgesia contraindication
* With impossibility to set up bilateral rectus sheath block
* Participation in another clinical study
* Pregnant women
* Patients deprived of their liberty by a judicial or administrative decision,
* Patients undergoing psychiatric care under articles L.3212-1 and L.3213-1 of the French Public Health Code
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Centre Hospitalier Régional Metz-Thionville

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Antoine BECRET, MD

Role: PRINCIPAL_INVESTIGATOR

CHR Metz Thionville Hopital de Mercy

Locations

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CHR Metz Thionville Hopital de Mercy

Metz, Moselle, France

Site Status RECRUITING

CHR Metz-Thionville Hopital Bel Air

Thionville, , France

Site Status NOT_YET_RECRUITING

Countries

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France

Central Contacts

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Arpiné EL NAR, PhD

Role: CONTACT

0033387557766

Facility Contacts

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Antoine BECRET, MD

Role: primary

387553069 ext. 0033

Arpiné EL NAR, PhD

Role: primary

0033387557766

References

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Maury T, Elnar A, Marchionni S, Frisoni R, Goetz C, Becret A. Effect of rectus sheath anaesthesia versus thoracic epidural analgesia on postoperative recovery quality after elective open abdominal surgery in a French regional hospital: the study protocol of a randomised controlled QoR-RECT-CATH trial. BMJ Open. 2023 May 23;13(5):e069736. doi: 10.1136/bmjopen-2022-069736.

Reference Type DERIVED
PMID: 37221022 (View on PubMed)

Other Identifiers

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2021-01-CHRMT

Identifier Type: -

Identifier Source: org_study_id