Effectiveness of Combined Fascial Plane Blocks for Postoperative Pain in Gynecologic Oncology Surgery

NCT ID: NCT07312825

Last Updated: 2025-12-31

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

Total Enrollment

94 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-01-01

Study Completion Date

2025-03-20

Brief Summary

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The goal of this prospective observational study is to compare the effectiveness of different postoperative analgesic techniques in patients undergoing major abdominal surgery for gynecologic oncology.

The main question is whether the combination of TAP block with Quadratus Lumborum Block (QLB) or Rectus Sheath Block (RSB) provides superior pain relief compared to TAP block alone.

All blocks were performed as part of routine clinical anesthesia practice according to the attending anesthesiologist's judgment. No randomization, allocation, or study-directed intervention was performed.

Patients were classified into three groups based on the block type they received during standard care:

Group 1: TAP Block Only

Group 2: TAP + QLB Combination

Group 3: TAP + RSB Combination

Postoperative data, including pain scores (VAS), opioid consumption, sedation level, heart rate, blood pressure, nausea/vomiting, and length of hospital stay, were collected prospectively.

The study aims to determine which block combination provides the best postoperative pain control and recovery profile in patients undergoing gynecologic oncology surgery.

Detailed Description

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This study is a prospective observational research designed to evaluate the postoperative analgesic effectiveness of different combinations of fascial plane blocks in patients undergoing gynecologic oncology surgery.

All blocks (Transversus Abdominis Plane \[TAP\] block, Quadratus Lumborum Block \[QLB\], and Rectus Sheath Block \[RSB\]) were performed as part of routine clinical anesthesia practice according to the attending anesthesiologist's preference.

No intervention, randomization, or protocol-directed procedure was applied for research purposes. After data collection, patients were classified into three groups based on the block type they had received in standard care:

TAP block only

TAP + QLB combination

TAP + RSB combination

The study prospectively compared postoperative pain scores (VAS), opioid consumption, time to mobilization, bowel function recovery, and length of hospital stay among these groups to determine the most effective analgesic strategy within routine practice.

This observational design reflects real-world anesthesia management and does not involve any experimental or interventional component.

Conditions

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Gynecologic Cancers Postoperative Pain Management

Keywords

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Fascial Plane Blocks for postoperative Analgesia (TAP Block, QLB, RSB) Gynecologic Oncology Surgery Postoperative Analgesia

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Group 1: TAP Block Only Group

Patients who received only Transversus Abdominis Plane (TAP) block as part of routine anesthesia practice. No additional regional block was performed.

Group 1:The Transversus Abdominis Plane (TAP) block

Intervention Type OTHER

Patients who received only Transversus Abdominis Plane (TAP) block as part of routine clinical anesthesia practice. No study-assigned intervention or randomization was performed. Data were collected prospectively from standard anesthesia records.

Group 2: TAP + QLB Combination

Patients who received both TAP block and Quadratus Lumborum Block (QLB) as part of standard clinical anesthesia management.

Group 2: TAP Block + Quadratus Lumborum Block (QLB)

Intervention Type OTHER

Patients who received TAP block combined with Quadratus Lumborum Block (QLB) during routine anesthesia management. This block combination was chosen by the attending anesthesiologist as part of standard care, not assigned by the study.

Group 3: TAP + RSB Combination

Patients who received both TAP block and Rectus Sheath Block (RSB) as part of standard clinical anesthesia management.

Group 3: TAP Block + Rectus Sheath Block (RSB)

Intervention Type OTHER

Patients who received TAP block combined with Rectus Sheath Block (RSB) as part of routine anesthesia practice. The block technique was performed according to clinical judgment, not as part of a study intervention.

Interventions

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Group 1:The Transversus Abdominis Plane (TAP) block

Patients who received only Transversus Abdominis Plane (TAP) block as part of routine clinical anesthesia practice. No study-assigned intervention or randomization was performed. Data were collected prospectively from standard anesthesia records.

Intervention Type OTHER

Group 2: TAP Block + Quadratus Lumborum Block (QLB)

Patients who received TAP block combined with Quadratus Lumborum Block (QLB) during routine anesthesia management. This block combination was chosen by the attending anesthesiologist as part of standard care, not assigned by the study.

Intervention Type OTHER

Group 3: TAP Block + Rectus Sheath Block (RSB)

Patients who received TAP block combined with Rectus Sheath Block (RSB) as part of routine anesthesia practice. The block technique was performed according to clinical judgment, not as part of a study intervention.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age 18 years or older.
* ASA physical status I-IV.
* Scheduled for major gynecologic oncology surgery (endometrial cancer, ovarian tumor, or cytoreductive surgery).
* Undergoing general anesthesia.
* Planned postoperative abdominal fascial plane block for pain management (TAP, TAP + QLB, or TAP + RSB).
* Able to provide written informed consent.

Exclusion Criteria

* Refusal to participate or inability to provide informed consent.
* Emergency surgery.
* Known allergy or contraindication to local anesthetics.
* Infection at the block site.
* Coagulopathy or anticoagulant use that contraindicates regional anesthesia.
* Pre-existing chronic pain conditions or chronic opioid use.
* Severe hepatic or renal insufficiency.
* Cognitive impairment that prevents reliable pain assessment.
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital

OTHER

Sponsor Role lead

Responsible Party

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Ayşe Menekşe Çakır

Doctor of Anesthesiology

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital

Ankara, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Yu S, Wen Y, Lin J, Yang J, He Y, Zuo Y. Combined rectus sheath block with transverse abdominis plane block by one puncture for analgesia after laparoscopic upper abdominal surgery: a randomized controlled prospective study. BMC Anesthesiol. 2024 Feb 9;24(1):58. doi: 10.1186/s12871-024-02444-6.

Reference Type RESULT
PMID: 38336613 (View on PubMed)

Zhu JL, Wang XT, Gong J, Sun HB, Zhao XQ, Gao W. The combination of transversus abdominis plane block and rectus sheath block reduced postoperative pain after splenectomy: a randomized trial. BMC Anesthesiol. 2020 Jan 23;20(1):22. doi: 10.1186/s12871-020-0941-1.

Reference Type RESULT
PMID: 31973700 (View on PubMed)

Akerman M, Pejcic N, Velickovic I. A Review of the Quadratus Lumborum Block and ERAS. Front Med (Lausanne). 2018 Feb 26;5:44. doi: 10.3389/fmed.2018.00044. eCollection 2018.

Reference Type RESULT
PMID: 29536008 (View on PubMed)

Other Identifiers

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FASIALBLOCKJinekoOnkoAnj

Identifier Type: -

Identifier Source: org_study_id