Postoperative Pain Control for Prostatectomy (TAP)

Nova Scotia Health Authority (NSHA)

Status: Completed

Conditions: Prostate Cancer

Treatments: Procedure: standard post op pain control; Procedure: Transverse Abdominal Plan (TAP)

Study type: Interventional

Funder types: Other

Identifiers

NCT00913068

version 2 July 13, 2009

Details and patient eligibility

About

The researchers propose to investigate a relatively new anesthetic procedure, in order to maximize patient comfort and minimize the use of narcotics after a radical prostatectomy.

Full description

Our current post operative analgesic strategy involves a multi-modal approach, using local injectable anesthetic around the incision and systemic medications (i.e. non-steroidal anti-inflammatories, acetaminophen and break-through doses of opiates). As the amount of opiates used can be significant, we have to be aware of their inherent risks. Opiates have an excellent pain control profile, working peripherally by decreasing the amount of neurotransmitters released from neurons involving noxious stimuli, and also in their central processing. Some of the more common adverse reactions are reparatory depression, sedation, confusion, delirium, nausea, pruritis, constipation, hypotension and bradycardia. Often it is these resulting side effects that extend the length of in hospital rehabilitation, and decrease a patient's overall satisfaction.

Thus we propose the use of a relatively new regional anesthetic technique be employed to further decrease the need for opiates in our prostatectomy patients' post-op course, while adequately controlling their pain.

Enrollment: 110 patients

Sex: Male

Ages: Under 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• prostate cancer for radical prostatectomy

Exclusion criteria

• chronic pain or opiate use

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

---

110 participants in 2 patient groups

TAP arm

Experimental group

Description:

in the experimental arm, the procedure will consist of the staff urologist injecting local anesthetic into the anterior abdominal wall bilaterally from the inside of the abdomen at the end of their surgery

Treatment:

Procedure: Transverse Abdominal Plan (TAP)

standard post operative pain control

Active Comparator group

Description:

Our current post operative analgesic strategy involves a multi-modal approach, using local injectable anesthetic around the incision and systemic medications (i.e. non-steroidal anti-inflammatories, acetaminophen and break-through doses of opiates). Some of the more common adverse reactions are reparatory depression, sedation, confusion, delirium, nausea, pruritis, constipation, hypotension and bradycardia. Often it is these resulting side effects that extend the length of in hospital rehabilitation, and decrease a patient's overall satisfaction.

Treatment:

Procedure: standard post op pain control