Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Class |
|---|---|
| St. Joseph's Healthcare Hamilton | OTHER |
Not provided
Not provided
Not provided
Not provided
Patients who have abdominal surgery will experience pain from the incision. The lumbar TAP block is a procedure used to reach the nerve endings in the abdominal wall so that there is a reduction in pain after surgery. Using ultrasound guidance, a solution of ropivacaine will be injected after surgery. The aim of this study is to determine the effect of changes in the volume of the injection.
Pain from a surgical incision happens in most patients. During the perioperative period, the use of the TAP block has been shown to reduce pain scores, opioid consumption and sedation scores. Also, there is a trend towards a reduction of post-operative nausea and vomiting. The aim of the block is to reach the distal nerve endings of the abdominal wall from T6 to L1 dermatomes using ultrasound guidance with a single shot of ropivacaine at different volumes. Currently, there is consensus about optimal procedure-specific volumes and local anesthetic concentrations for lumbar TAP blocks. This is a pilot study and the purpose being is it feasible to do a large scale clinical study to determine the influence of increasing the local anesthetic volume.
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 20mLs of 0.5% ropivacaine per side | Experimental |
| |
| 30mLs of 0.33% ropivacaine per side | Experimental |
| |
| 40mLs of 0.25% ropivacaine per side | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ropivacaine | Drug | 20mLs of 0.5% |
|
|
| Measure | Description | Time Frame |
|---|---|---|
| To assess the feasibility of a large scale clinical study to determine the influence on increasing the local anesthetic volume. | This will be shown as a number and a percenttage of patients recruited and randomized. | 6 month |
| Measure | Description | Time Frame |
|---|---|---|
| Using ice and pinprick, determine the dermatomal block distribution at 2,6,12,24 and 48 hours post block. | The assessor will measure the extend of the block distribution at the various time intervals. | 48 hours |
| Pain scores at 2,6,12,24, and 48 hours post-block. |
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Mauricio Forero, MD | McMaster University/St. Joseph's Healthcare | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| St. Joseph's Healthcare Hamilton | Hamilton | Ontario | L8N 4A6 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 20175754 | Background | Petersen PL, Mathiesen O, Torup H, Dahl JB. The transversus abdominis plane block: a valuable option for postoperative analgesia? A topical review. Acta Anaesthesiol Scand. 2010 May;54(5):529-35. doi: 10.1111/j.1399-6576.2010.02215.x. Epub 2010 Feb 17. | |
| 19020158 | Background | Carney J, McDonnell JG, Ochana A, Bhinder R, Laffey JG. The transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy. Anesth Analg. 2008 Dec;107(6):2056-60. doi: 10.1213/ane.0b013e3181871313. |
Not provided
Not provided
Not provided
| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
Not provided
Not provided
| ID | Term |
|---|---|
| D000077212 | Ropivacaine |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Ropivacaine | Drug | 30mLs of 0.33% |
|
|
| Ropivacaine | Drug | 40mLs of 0.25% |
|
|
Using a visual analog scale, patient pain scores will be assessed. |
| 48 hours |
| Patient-controlled analgesia opioid requirements at 2,6,12,24 and 48 post-block. | Record drug consumption at the time intervals | 48 hours |
| Incidence of post-operative nausea and vomiting at 2,6,12,24, and 48 hours. | 48 hours |
| Block failure rate. | Block failure rate is defined as the lack of any sensory block following the TAP block. | 48 hours |
| Patient's overall satisfaction. | Using a LIKERT score, patient satisfaction will be measured. | 48 hours |
| Discharge time from PACU. | The time in which the patient is discharged from the recovery room. | 24 hours |
| 27965789 | Derived | Forero M, Heikkila A, Paul JE, Cheng J, Thabane L. Lumbar transversus abdominis plane block: the role of local anesthetic volume and concentration-a pilot, prospective, randomized, controlled trial. Pilot Feasibility Stud. 2015 Mar 25;1:10. doi: 10.1186/s40814-015-0002-6. eCollection 2015. |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D000588 |
| Amines |