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Transversalis fascia plane block (TFPB) has been studied and has shown to be very effective in controlling postoperative pain after caesarean section but has not been studied in open gynecologic surgery with transverse incision. Inadequate pain control after open gynecologic surgery is associated with negative consequences such as chronic pelvic pain. The investigators aimed to evaluate the efficacy of TFPB in controlling postoperative pain after open gynecologic surgery with transverse incision.
A randomized controlled trial study in which comparing US-guided TFPB vs conventional pain control in open gynecologic surgery
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| control | No Intervention | Patients in control group will receive general anesthesia for open gynecologic surgery. | |
| TFPB | Experimental | Patients in this study group will receive general anesthesia and US-guided bilateral TFPB after wound closure. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| US-guided transversalis fascia plane block | Procedure | US-guided bilateral transversalis fascia plane block, using Sonotap 110 mm and 0.25% bupivacaine 20 ml on each side, will be done after wound closure. |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative 24 hours morphine requirement | 24 hours |
| Measure | Description | Time Frame |
|---|---|---|
| postoperative pain score | 1 hour, 6 hours, 24 hours | |
| Side effects from postoperative opioids | nausea vomiting, itching, respiratory depression | 24 hours |
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Inclusion Criteria:
Exclusion Criteria:
This study aims to evaluate pain after open gynecologic surgery, so only female are eligible.
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| Name | Affiliation | Role |
|---|---|---|
| Assist. Prof. Dr. Preeyaphan Arunakul, M.D., FRCAT | Faculty of Medicine, Thammasat University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Anesthesiology, Faculty of Medicine, Thammasat University | Pathum Thani | 12121 | Thailand |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | Management of Chronic Pelvic Pain. In: Hibner M, editor. Management of Chronic Pelvic Pain: A Practical Manual. Cambridge: Cambridge University Press; 2021. p. i-ii. | ||
| 25806905 | Background | van Rijckevorsel DC, de Vries M, Schreuder LT, Wilder-Smith OH, van Goor H. Risk factors for chronic postsurgical abdominal and pelvic pain. Pain Manag. 2015;5(2):107-16. doi: 10.2217/pmt.14.47. | |
| 36111099 |
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| Incidence of chronic pelvic pain | 3 months |
| Background |
| Chilkoti GT, Gaur D, Saxena AK, Gupta A, Agarwal R, Jain S. Ultrasound-guided transversalis fascia plane block versus wound infiltration for both acute and chronic post-caesarean pain management - A randomised controlled trial. Indian J Anaesth. 2022 Jul;66(7):517-522. doi: 10.4103/ija.ija_173_22. Epub 2022 Jul 22. |
| 30886131 | Background | Black ND, Malhas L, Jin R, Bhatia A, Chan VWS, Chin KJ. The analgesic efficacy of the transversalis fascia plane block in iliac crest bone graft harvesting: a randomized controlled trial. Korean J Anesthesiol. 2019 Aug;72(4):336-343. doi: 10.4097/kja.d.18.00352. Epub 2019 Mar 19. |
| 33785672 | Background | Fouad AZ, Abdel-Aal IRM, Gadelrab MRMA, Mohammed HMES. Ultrasound-guided transversalis fascia plane block versus transmuscular quadratus lumborum block for post-operative analgesia in inguinal hernia repair. Korean J Pain. 2021 Apr 1;34(2):201-209. doi: 10.3344/kjp.2021.34.2.201. |
| 36635627 | Background | Geng ZY, Zhang Y, Bi H, Zhang D, Li Z, Jiang L, Song LL, Li XY. Addition of preoperative transversus abdominis plane block to multimodal analgesia in open gynecological surgery: a randomized controlled trial. BMC Anesthesiol. 2023 Jan 12;23(1):21. doi: 10.1186/s12871-023-01981-w. |
| 33779215 | Background | Wilson SH, Hellman KM, James D, Adler AC, Chandrakantan A. Mechanisms, diagnosis, prevention and management of perioperative opioid-induced hyperalgesia. Pain Manag. 2021 Apr;11(4):405-417. doi: 10.2217/pmt-2020-0105. Epub 2021 Mar 29. |
| 22157741 | Background | VanDenKerkhof EG, Hopman WM, Goldstein DH, Wilson RA, Towheed TE, Lam M, Harrison MB, Reitsma ML, Johnston SL, Medd JD, Gilron I. Impact of perioperative pain intensity, pain qualities, and opioid use on chronic pain after surgery: a prospective cohort study. Reg Anesth Pain Med. 2012 Jan-Feb;37(1):19-27. doi: 10.1097/AAP.0b013e318237516e. |
| 32500680 | Background | Ohnesorge H, Gunther V, Grunewald M, Maass N, Alkatout I. Postoperative pain management in obstetrics and gynecology. J Turk Ger Gynecol Assoc. 2020 Dec 4;21(4):287-297. doi: 10.4274/jtgga.galenos.2020.2020.0024. Epub 2020 Jun 5. |
| 37363541 | Background | Amberbir WD, Bayable SD, Fetene MB. The prevalence and factors associated with acute postoperative pain in elective gynecologic surgical patients at two referral hospitals in Addis Abeba, Ethiopia, 2021: a cross-sectional study. Ann Med Surg (Lond). 2023 Apr 27;85(6):2506-2511. doi: 10.1097/MS9.0000000000000716. eCollection 2023 Jun. |
| 19495909 | Background | Hebbard PD. Transversalis fascia plane block, a novel ultrasound-guided abdominal wall nerve block. Can J Anaesth. 2009 Aug;56(8):618-20. doi: 10.1007/s12630-009-9110-1. Epub 2009 Jun 4. No abstract available. |
| 39039833 | Background | Pinarbasi A, Altiparmak B, Korkmaz Toker M, Pirincci F, Ugur B. Ultrasound-guided transversalis fascia plane block or transversus abdominis plane block for recovery after caesarean section: A randomised clinical trial. Eur J Anaesthesiol. 2024 Oct 1;41(10):769-778. doi: 10.1097/EJA.0000000000002041. Epub 2024 Jul 22. |