Transversus Abdominis Plane Blocks With Abdominoplasty (TAPA)

Clinique Saint-Jean, Bruxelles

Status and phase: Unknown; Phase 4

Conditions: Post Operative Pain

Treatments: Drug: Ropivacaine 0.25%, 0.5 ml/kg

Study type: Interventional

Funder types: Other

Identifiers

NCT01278264

ANESAB001

Details and patient eligibility

About

Comparing morphine consumption and recovery with two different TAP block techniques after abdominoplasty.

Full description

TAP blocks have the potential to become an important part of multi-modal analgesia after abdominal surgery (1,2). Originally Dr J McDonnell described a blind double pop technique, trough the triangle of Petit, with up to 48 hours of analgesia (3,4). Dr P Hebbard described an ultrasound based technique with a subcostal (for supra-umbilical analgesia) and an axillary mid-line injection (for sub-umbilical analgesia) in the TAP, with reported analgesia for up to 8 hours (5,6). Recently Dr J McDonnell presented data showing para vertebral spread (up to L5) of the (high dose, low concentration) local anaesthetic explaining the prolonged analgesic effect (7,8). In 2007 Dr Blanco described an ultrasound guided technique for the posterior infiltration as performed by McDonnell (9). Our limited observational comparison between both block techniques confirms this difference. We decided to compare both techniques (the ultrasound guided single shot subcostal injection, the aTAP-group (Hebbard is from Australia) and the ultrasound guided posterior injection, the iTAP-group (McDonnell is from Ireland). We will use the same volume and concentration of local anesthetic and we will asses their analgesic efficacy and improvement in quality of recovery.

Enrollment: 60 estimated patients

Sex: Female

Ages: 18 to 75 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Eligible for abdominoplasty
• ASA 1-2
• Fluent french/dutch/english

Exclusion criteria

• History of allergy to local anaesthetics
• Chronic opioids abuse
• Pregnant patients

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: Single Blind

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60 participants in 2 patient groups

iTAP-group

Active Comparator group

Description:

Posterior approach for TAP: ultrasound guided bilateral needle insertion in the transversus abdominis plane, anterior to the quadratus lumborum muscle

Treatment:

Drug: Ropivacaine 0.25%, 0.5 ml/kg

Drug: Ropivacaine 0.25%, 0.5 ml/kg

aTAP-group

Active Comparator group

Description:

Subcostal approach for TAP: US guided needle insertion in the transversus abdominis plane, lateral to rectus sheet

Treatment:

Drug: Ropivacaine 0.25%, 0.5 ml/kg

Drug: Ropivacaine 0.25%, 0.5 ml/kg