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The goal of this clinical trial is to learn if the regional anesthesia technique "TAP block" provide more analgesia when performed before or after the surgery. The main questions it aims to answer are:
Does preoperative TAP block provide greater analgesia than postoperative TAP block? Patients receiving preoperative TAP block will have less pain and take less painkillers than patients receiving postoperative TAP block?
Participants will:
Receive preoperative or postoperative TAP block They will be asked about their pain levels during the hospital stay.
The TAP block is a safe, easy-to-perform, and effective technique for managing postoperative pain. It reduces opioid consumption and increases patient satisfaction. Despite recent studies indicating that postoperative TAP block might be more effective than preoperative TAP block in reducing opioid use within 24 hours, the optimal timing of its administration (before or after surgery) remains unclear.
In this study we will compare preoperative to postoperative TAP block in patients undergoing laparoscopic cholecistectomy.
The primary aim of this study is to determine the difference in postoperative pain control between preoperative and postoperative TAP block administration in patients undergoing laparoscopic cholecystectomy.
The primary objective will be to evaluate the difference in postoperative pain at rest, 24 hours after surgery, between patients receiving preoperative versus postoperative TAP block. Pain will be assessed using the Numeric Rating Scale (NRS) from 0 to 10.
Secondary objectives will be intraoperative and postoperative opioids, postoperative nausea and vomiting, pain at resnt and on movement at 0,6,12,24 hours.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Preoperative TAP block | Experimental | Patients will receive a preoperative TAP block with 40 mL (20 mL on the right side + 20 mL on the left side) of Ropivacaine 0.4% |
|
| Postoperative TAP block | Active Comparator | Patients will receive a postoperative TAP block with 40 mL (20 mL on the right side + 20 mL on the left side) of Ropivacaine 0.4% |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Preoperative TAP Block | Procedure | Patients will receive preoperative TAP block |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Patient reported pain on movement at 24 hours after the surgery | Pain will be assessed with the 11 points NRS scale (0-10) | At the 24th hour after the end of the surgery. |
| Measure | Description | Time Frame |
|---|---|---|
| Patient reported pain on movement (cough) at the end of the surgery | Pain will be assessed with the 11 points NRS scale (0-10) | At the end of the surgery. |
| Patient reported pain on rest at the end of the surgery |
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Inclusion Criteria
Exclusion Criteria
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Silvia De Pinto, MD | Contact | +390496739 | silvia.depinto@aopd.veneto.it |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital of Padua | Recruiting | Padua | Italy | 35127 | Italy |
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Participant will be masked as the intervention (TAP block) will be performed after induction of general anesthesia Outcome assessor will be unaware of the group assignment
| Postoperative TAP block |
| Procedure |
Patients will receive postoperative TAP block |
|
Pain will be assessed with the 11 points NRS scale (0-10)
| At the end of the surgery. |
| Patient reported pain on rest at 6 hours after the surgery | Pain will be assessed with the 11 points NRS scale (0-10) | At the 6th hour after the end of the surgery. |
| Patient reported pain on movement at 6 hours after the surgery | Pain will be assessed with the 11 points NRS scale (0-10) | At the 6th hour after the end of the surgery. |
| Patient reported pain on rest at 12 hours after the surgery | Pain will be assessed with the 11 points NRS scale (0-10) | At the 12th hour after the end of the surgery. |
| Patient reported pain on movement at 12 hours after the surgery | Pain will be assessed with the 11 points NRS scale (0-10) | At the 12th hour after the end of the surgery. |
| Patient reported pain on rest at 24 hours after the surgery | Pain will be assessed with the 11 points NRS scale (0-10) | At the 24th hour after the end of the surgery. |
| Difference in intraoperative opioids | Difference in intraoperative fentanest in micrograms | From the enrollment to the extubation |
| Difference in postoperative opioids | Difference in postoperative morphine in milligrams | From the extubation to the 24th postoperative hours |
| Number of participants experiencing postoperative nausea and vomiting | Patients will be asked to report nausea and or vomiting in the postoperative period | From extubation to the 24th postoperative hour |