Analgesic Efficacy of Surgeon-administered Transversus Abdominis Plane Blocks for Caesarean Section.

University of Calgary

Status: Enrolling

Conditions: Cesarean Section Complications; Pain, Postoperative

Treatments: Other: Surgeon-administered Transversus Abdominis Plane Block 0.25% bupivicaine 0.25 mL/kg

Study type: Interventional

Funder types: Other

Identifiers

NCT06324942

REB24-0349

Details and patient eligibility

About

The purpose of this research study is to evaluate whether or not adding a Transversus Abdominis Plane Block (TAP block) improves pain control for patients having a cesarean section. A TAP block is a type of nerve block where at the end of the surgery an injection of a long acting local anesthetic is made into the abdominal wall. In studies in patient's having other abdominal surgeries this has reduced the amount of narcotics patients need for pain control. This may also led to patients being more active after surgery and maybe spending less time in hospital.

Full description

Randomized clinical trial of Transversus Abdominis Plane Block (TAP block) at Cesarean Section.

Enrollment: 80 estimated patients

Sex: Female

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• ASA status II to III
• All patients undergoing elective CS under regional anesthesia at any gestational age.

Exclusion criteria

• • Known drug allergy to local anesthetics
• Planned general anesthetic
• NSAID use contraindicated post partum
• Chronic pain disorder or chronic narcotic use/dependence
• Planned vertical abdominal incision
• Planned Cesarean Hysterectomy.
• Placenta Previa or suspected Placenta Accreta

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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80 participants in 2 patient groups

Surgeon-administered Transversus Abdominis Plane Block (TAP block)

Experimental group

Description:

After uterine closure, the anterior abdominal wall on the contralateral side to the surgeon is elevated and retracted laterally by an assistant. The bowel and uterus is retracted using the surgeon's non-dominant hand, with or without a sponge. Under direct visualization, a blunted spinal needle is inserted lateral to the rectus muscle to avoid injury to inferior epigastric blood vessels. The needle is then gently advanced through the transversus abdominis fascia into the TAP plane, identified at loss of resistance, or 'a pop'. After aspiration to confirm no accidental placement of the needle intravascularly, local anaesthetic is infiltrated into the transverse abdominis plane through the parietal peritoneum by the surgeon at a prespecified dose of 0.25% bupivicaine 0.25 mL/kg (approximately 20cc). This is repeated on the contralateral side, after which closure of the fascia, subcutaneous tissue, and skin were performed.

Treatment:

Other: Surgeon-administered Transversus Abdominis Plane Block 0.25% bupivicaine 0.25 mL/kg

No TAP block

No Intervention group

Description:

A sham procedure will not be performed but the patient will be unaware of whether or not an injection was done.