Transversus Abdominis Plan Block Versus Rectus Sheath Block

NCT ID: NCT06897345

Last Updated: 2025-03-26

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 60 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-05-01
• Study Completion Date: 2025-12-01

Brief Summary

The investigator aims to compare the analgesic efficacy of Transversus Abdominis Plan Block and Rectus Sheath Block which are used to prevent intraoperative and postoperative pain and reduce the use of opioid in abdominoplasty operations.

Detailed Description

Abdominoplasty is a frequently performed surgical procedure in aesthetic and plastic surgery. It is performed to solve the pain caused by the large abdomen, respiratory distress and aesthetic problems. Since large tissue excision is made and a large area is worked on, providing perioperative pain control is also important to prevent both postoperative respiratory distress and postoperative chronic pain formation.

In order to prevent both intraoperative and postoperative pain and to reduce opioid use, peripheral nerve blocks that provide analgesia on the abdominal wall can be applied to patients before the surgical incision. The most well-known of these blocks is the Transversus Abdominis Plane block. Another block that has been proven effective in abdominal surgery is the Rectus Sheath block. In the Transversus Abdominis Plane block (TAP), local anesthetic is injected into the fascia between the internal oblique and transversus abdominis muscles, aiming for analgesia. It provides multidermatomal sensory block by spreading the local anesthetic agent in the fascial area. The Rectus Sheath (RK) block is also a preferred plan block in abdominoplasty surgery. In this block, local anesthetic agent is injected between the rectus muscle and the posterior rectus sheath to achieve analgesia.

Although the effectiveness of both blocks has been shown mostly in abdominoplasty operations, there is no publication in the literature showing and comparing their effectiveness in abdominoplasty operations. With this study, The investigator aimed to compare the analgesic effectiveness of the two blocks in patients who will undergo abdominoplasty operations.

Conditions

Abdominal Obesity; Postoperative Pain; Postoperative Complications

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: PREVENTION
• Blinding Strategy: DOUBLE

Study Groups

transversus abdominis plane block

After administering 0.02 mg/kg midazolam for sedation to Group TAP patients, they will be placed in the supine position on both sides under sterile conditions using the high-frequency linear probe of the Esaote CA631 brand ultrasound, and the linear probe will be slid from the bilateral umblicus level to the midaxillary line, and when the internal and external oblique muscles are seen, the needle will be advanced from medial to lateral in an inplane manner, and the fascia between the internal oblique and transversus abdominis muscles will be reached, and after negative aspiration, 20 cc of 0.25% bubivacaine will be injected.

Group Type: ACTIVE_COMPARATOR

transversus abdominis plane block

Intervention Type: PROCEDURE

The transversus abdominis plane (TAP) block is a regional anesthesia technique used primarily to provide pain relief for patients undergoing surgery in the abdominal region. The TAP block targets the nerves that supply sensations to the skin and muscles of the abdominal wall.

rectus sheat block

After administering 0.02 mg/kg midazolam for sedation, in the supine position, under sterile conditions, using the high-frequency linear probe of the Esaote CA631 brand ultrasound, 1 cm laterally over the umblicus, and after negative aspiration between the rectus muscle and the posterior rectus sheath, 20 cc of 0.25% bubivacaine will be injected (bilateral). 15 minutes after the block is applied, general anesthesia will be applied to the patients in both groups with 1 mcg/kg fentanyl, 2 mg/kg propofol, 0.6 mg/kg rocuronium intravenously and they will be orotracheal intubated. Intraoperative remifentanil needs will be recorded. Within the scope of multimodal analgesia, 1 g paracetamol will be administered to all patients 30 minutes before the end of the operation and 3 mg/kg sugammadex will be administered at the end of the operation and they will be extubated.

Group Type: ACTIVE_COMPARATOR

rectus sheat block

Intervention Type: PROCEDURE

The rectus sheath block is a type of regional anesthesia used primarily for pain management in the abdominal area. It involves injecting local anesthetic into the rectus sheath, which is the fibrous sheath that envelops the rectus abdominis muscle. This block targets the lower intercostal nerves as they traverse through the sheath, thereby providing analgesia to the anterior abdominal wall.

Interventions

transversus abdominis plane block

The transversus abdominis plane (TAP) block is a regional anesthesia technique used primarily to provide pain relief for patients undergoing surgery in the abdominal region. The TAP block targets the nerves that supply sensations to the skin and muscles of the abdominal wall.

Intervention Type: PROCEDURE

rectus sheat block

The rectus sheath block is a type of regional anesthesia used primarily for pain management in the abdominal area. It involves injecting local anesthetic into the rectus sheath, which is the fibrous sheath that envelops the rectus abdominis muscle. This block targets the lower intercostal nerves as they traverse through the sheath, thereby providing analgesia to the anterior abdominal wall.

Intervention Type: PROCEDURE

Other Intervention Names

bupivakain; bupivakain

Eligibility Criteria

Inclusion Criteria

Patients who will undergo elective abdominoplasty

• Patients between the ages of 18-65
• ASA (American Society of Anesthesiologists) I-II-III patients
• Patients with a body weight between 50-80 kg

Exclusion Criteria

• - ASA IV patient group
• Patients under 18 years of age
• Patients without cooperation
• Patients with chronic alcohol use
• Patients in whom peripheral plane block application is contraindicated (infection at the application site, coagulopathy, local anesthetic allergy)
• Patients who do not want to participate in the study

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Sisli Hamidiye Etfal Training and Research Hospital

OTHER

Sponsor Role: lead

Responsible Party

Aysel Salkaya

Anesthesiologist

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

LEYLA KILINC

Role: STUDY_CHAIR

şişli etfal eğitim araştırma hastanesi

Locations

Sisli Hamidiye Etfal Training Hospital

Istanbul, , Turkey (Türkiye)

Countries

Turkey (Türkiye)

Central Contacts

AYSEL SALKAYA

Role: CONTACT

ayselsalkaya34@hotmail.com

+905062046172

MUSTAFA ALTINAY

Role: CONTACT

m_altinay@yahoo.com

05333914422

Facility Contacts

MUSTAFA ALTINAY

Role: primary

m_altinay@yahoo.com

05333914422

Other Identifiers

salkaya-1

Identifier Type: -

Identifier Source: org_study_id