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This study aimed to evaluate the impact of ultrasound-guided bilateral transversus abdominis plane block combined with rectus sheath block on postoperative pain and recovery after robotic colectomy under an enhanced recovery after surgery (ERAS) protocol.
Postoperative pain remains an important concern after robotic colectomy despite the implementation of enhanced recovery after surgery (ERAS) protocols. Although robotic colectomy is associated with smaller incisions and faster recovery than conventional open surgery, postoperative pain may still impair early ambulation, gastrointestinal recovery, and patient satisfaction. Multimodal analgesia strategies, including acetaminophen and nonsteroidal anti-inflammatory drugs, are commonly used in ERAS pathways to reduce opioid consumption and opioid-related adverse effects. However, postoperative pain during movement and opioid requirements remain clinically relevant issues.
Ultrasound-guided transversus abdominis plane (TAP) block has been reported to reduce postoperative pain and opioid consumption after colorectal surgery. In addition, rectus sheath block (RSB) may provide further analgesic benefit for midline abdominal incision pain. Nevertheless, the additional clinical benefit of combining TAP block and RSB in patients undergoing robotic colectomy within an established ERAS pathway has not been fully investigated.
This study aimed to evaluate the impact of ultrasound-guided bilateral TAP block combined with RSB on postoperative pain and recovery following robotic colectomy. Additionally, we investigated the influence of TAP block combined with RSB on postoperative opioid consumption, postoperative nausea and vomiting, early ambulation, gastrointestinal recovery, and length of hospital stay after robotic colectomy under ERAS management.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TAP+RSB-R group | Experimental | TAP+RS block with ropivacaine and standard analgesic care |
|
| TAP+RSB-S group | Placebo Comparator | TAP+RS block with saline and standard analgesic care |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ropivacaine | Drug | TAP+RS block using ropivacaine |
| |
| Saline |
| Measure | Description | Time Frame |
|---|---|---|
| Visual Analogue Scale at Resting | Postoperative 48 hours | |
| Visual Analogue Scale at Movement | Postoperative 48 hours | |
| Postoperative Opioid Consumption | Postoperative 48 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative Adverse Event | From surgery until hospital discharge | |
| Time to First Ambulation | From surgery until hospital discharge | |
| Time to First Flatus |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Wei-Cheng Tseng, MD | Contact | 886-2-8792-3311 | 24159 | ndmc_wechern@yahoo.com.tw |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tri-Service General Hospital | Taipei | Taiwan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37379171 | Result | Yang R, Wang J, Shi DW, Niu Y, Zhou XD, Liu Y, Xu GH. The Efficiency of Multipoint Rectus Sheath Block Based on Incision Location in Laparoscopic-Assisted Colorectal Surgery: A Randomized Clinical Trial. Dis Colon Rectum. 2023 Dec 1;66(12):1578-1586. doi: 10.1097/DCR.0000000000002895. Epub 2023 Jun 28. | |
| 35953018 | Result |
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There is no plan to share
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| ID | Term |
|---|---|
| D015179 | Colorectal Neoplasms |
| ID | Term |
|---|---|
| D007414 | Intestinal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
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| ID | Term |
|---|---|
| D000077212 | Ropivacaine |
| D012965 | Sodium Chloride |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
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| Drug |
TAP+RS block with saline |
|
| From surgery until hospital discharge |
| Hospital Stay | At hospital discharge |
| Liu KY, Lu YJ, Lin YC, Wei PL, Kang YN. Transversus abdominis plane block for laparoscopic colorectal surgery: A meta-analysis of randomised controlled trials. Int J Surg. 2022 Aug;104:106825. doi: 10.1016/j.ijsu.2022.106825. Epub 2022 Aug 8. |
| 35295183 | Result | Viderman D, Aubakirova M, Abdildin YG. Transversus Abdominis Plane Block in Colorectal Surgery: A Meta-Analysis. Front Med (Lausanne). 2022 Feb 23;8:802039. doi: 10.3389/fmed.2021.802039. eCollection 2021. |
| 29402875 | Result | Liu L, Xie YH, Zhang W, Chai XQ. Effect of Transversus Abdominis Plane Block on Postoperative Pain after Colorectal Surgery: A Meta-Analysis of Randomized Controlled Trials. Med Princ Pract. 2018;27(2):158-165. doi: 10.1159/000487323. Epub 2018 Feb 1. |
| 29381824 | Result | Hain E, Maggiori L, Prost A la Denise J, Panis Y. Transversus abdominis plane (TAP) block in laparoscopic colorectal surgery improves postoperative pain management: a meta-analysis. Colorectal Dis. 2018 Apr;20(4):279-287. doi: 10.1111/codi.14037. |
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D012002 | Rectal Diseases |
| D000588 |
| Amines |
| D002712 | Chlorides |
| D006851 | Hydrochloric Acid |
| D017606 | Chlorine Compounds |
| D007287 | Inorganic Chemicals |
| D017670 | Sodium Compounds |