Postoperative Analgesia of TAP Block for Laparoscopic Sleeve Gastrectomy

NCT ID: NCT06156657

Last Updated: 2023-12-05

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

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-01-30

Study Completion Date

2023-12-15

Brief Summary

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many methods were considered to control postoperative pain in laparoscopic bariatic surgery including non steroidal anti-inflammatory drugs, opioids and neuraxial block

but subcostal (TAP) block has provided good analgesic effect when used as a part of multimodal analgesia in bariatric surgery due to lack of visceral block

Detailed Description

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Since long time opioid have been used to control postoperative pain in bariatric surgery However, an increasing awareness of opioid-related adverse events, including respiratory depression, paralytic ileums, and sedation, constipation has led to a shift towards utilizing opioid-sparing techniques for postoperative analgesia As neuroaxial block and ultrasound guided nerve blocks

As the transverse abdominis plane (TAP) block which is of increasing interest nowadays (Basaran B, et al 2015)

The ultrasound-guided oblique SCTAP block, first described by Hebbard et al., has the potential to provide analgesia for both upper and lower abdominal surgery. There is a growing consensus that the SCTAP block provides better analgesia for upper abdominal incisions

The TAP block via various approaches provides some advantages over neuraxial anesthesia (Ganapathy Set al 2015). For example, TAP blocks are associated with a lower use of intraoperative phenylephrine and a lesser degree of intraoperative blood pressure changes. The SCTAP block may be utilized in cases in which neuraxial anesthesia is contraindicated, such as patients with coagulation issues or infection at the epidural puncture site. Although the SCTAP block provides sensory blockade of the abdominal wall, it is lacking in coverage of visceral pain (Lissauer J,et al 2014).

The lack of visceral pain analgesia may require the use of additional methods of postoperative pain control such as intravenous opioids or non-narcotic analgesics.

Conditions

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Postoperative Pain

Keywords

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subcostal TAP laparoscopic sleeve gastrectomy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors
The patient and the anasthesiologist who perform postoperative pain will not know the group.

Study Groups

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TAP group

patients candidate for laparoscopic sleeve gastrectomy to receive GA and subcostal TAP block to control postoperative pain and minimize opioid consumption

Group Type ACTIVE_COMPARATOR

subcostal TAP block

Intervention Type OTHER

Comparison between subcostal TAP block and opioids for postoperative pain after laparscopic sleeve gastrectomy

Control group

healthy controls candidate for laparoscopic sleeve gastrectomy to receive GA only opioids were used

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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subcostal TAP block

Comparison between subcostal TAP block and opioids for postoperative pain after laparscopic sleeve gastrectomy

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age 20-60 years
* ASA Ι-ΙΙ
* BMI \>35

Exclusion Criteria

* Patient refusal.
* Allergy to study drugs.
* Infection at site of injection.
Minimum Eligible Age

21 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Al-Azhar University

OTHER

Sponsor Role lead

Responsible Party

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Ismail Mohamed Abdelgawad Ahmed

DOCTOR

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Al Azhar University

Cairo, Naser City, Egypt

Site Status RECRUITING

Countries

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Egypt

Central Contacts

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Ismail M Ahmed, prof

Role: CONTACT

Phone: 00201117310053

Email: [email protected]

Khaled Elsheshtawy M Sherif, lecturer

Role: CONTACT

Phone: 00201064819857

Email: [email protected]

Facility Contacts

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Ahmed M Selim, director

Role: primary

References

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Basaran B, Basaran A, Kozanhan B, Kasdogan E, Eryilmaz MA, Ozmen S. Analgesia and respiratory function after laparoscopic cholecystectomy in patients receiving ultrasound-guided bilateral oblique subcostal transversus abdominis plane block: a randomized double-blind study. Med Sci Monit. 2015 May 7;21:1304-12. doi: 10.12659/MSM.893593.

Reference Type BACKGROUND
PMID: 25948166 (View on PubMed)

Hebbard PD, Barrington MJ, Vasey C. Ultrasound-guided continuous oblique subcostal transversus abdominis plane blockade: description of anatomy and clinical technique. Reg Anesth Pain Med. 2010 Sep-Oct;35(5):436-41. doi: 10.1097/aap.0b013e3181e66702.

Reference Type BACKGROUND
PMID: 20830871 (View on PubMed)

Ganapathy S, Sondekoppam RV, Terlecki M, Brookes J, Das Adhikary S, Subramanian L. Comparison of efficacy and safety of lateral-to-medial continuous transversus abdominis plane block with thoracic epidural analgesia in patients undergoing abdominal surgery: A randomised, open-label feasibility study. Eur J Anaesthesiol. 2015 Nov;32(11):797-804. doi: 10.1097/EJA.0000000000000345.

Reference Type BACKGROUND
PMID: 26426576 (View on PubMed)

Lissauer J, Mancuso K, Merritt C, Prabhakar A, Kaye AD, Urman RD. Evolution of the transversus abdominis plane block and its role in postoperative analgesia. Best Pract Res Clin Anaesthesiol. 2014 Jun;28(2):117-26. doi: 10.1016/j.bpa.2014.04.001. Epub 2014 May 9.

Reference Type BACKGROUND
PMID: 24993433 (View on PubMed)

Other Identifiers

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TAP block

Identifier Type: -

Identifier Source: org_study_id