Optimal peripheral nerve block after minimally invasive colon surgery - a study protocol for a randomised trial

Area of Science:

• Anesthesiology and Pain Management
• Surgical Oncology
• Clinical Trials

Background:

• Transversus abdominis plane (TAP) blocks are utilized for post-operative pain control.
• The comparative efficacy of different TAP block techniques in minimally invasive colon surgery is not well-established.

Purpose of the Study:

• To investigate the effect of ultrasound-guided TAP (US-TAP) and laparoscopic-assisted TAP (L-TAP) on post-operative pain.
• To compare the efficacy of US-TAP and L-TAP against placebo in patients undergoing minimally invasive colon surgery.

Main Methods:

• A double-blind, randomized, controlled multicenter trial involving 360 adult patients.
• Participants were randomized into three groups: active US-TAP/placebo L-TAP, placebo US-TAP/active L-TAP, or placebo US-TAP/placebo L-TAP.
• Primary outcome: morphine dose equivalents in the first 24 hours post-surgery; secondary outcomes: pain, length of stay, nausea/vomiting, and quality of recovery.

Main Results:

• This section is to be filled once the study results are available.
• The study is designed to determine superiority of active TAP blocks over placebo and non-inferiority of L-TAP to US-TAP.
• Statistical analysis will be performed using intention-to-treat and per-protocol methods.

Conclusions:

• This trial represents the first blinded, multicenter comparison of L-TAP, US-TAP, and placebo in clinical practice.
• The findings have the potential to define the role of TAP blocks in enhancing post-operative pain management for minimally invasive colon surgery.
• This research aims to provide evidence-based guidance for optimizing patient recovery pathways.