None listed
Conditions
Brief summary
Epidural analgesia is considered to be the golden standard for postoperative analgesia after abdominal surgery. However, rare but serious central neuraxial events have been reported. In recent years transversus abdominis plane (TAP) block has been used to obtain postoperative analgesia after abdominal surgery. This peripheral nerve blocking technique is not associated with the central neuraxis complications described with epidural analgesia. The technique is easy to perform blindly or under ultrasound guidance and can be used when an epidural technique is contraindicated. Postoperative monitoring for TAP block has a lower complexity level compared to epidural analgesia. Although TAP block has been shown to be effective, no studies have been published comparing continuous TAP block with epidural analgesia. The aim of this study is to compare Epidural Catheter Technique vs. Transversus Abdominis Plane (TAP) Catheter Technique for Abdominal Surgery in regards to technical difficulty, analgesic efficacy, and patient satisfaction.
Interventions
In the EPIDURAL group the epidural catheter will be placed pre-operatively. Only a test block will be performed to ensure correct placement of the catheter. At the end of the case in the post anaesthetic care unit (PACU) a bolus of 8-15 ml of Ropicavaine 0.2% will be administered through the epidural catheter, followed by an infusion of 5-15 ml/hr (based on clinical effect) of Ropivacaine 0.2% for 3 days.
In TAP group bilateral catheters will be inserted in the transversus Abdominis Plane usin
In the EPIDURAL group the epidural catheter will be placed pre-operatively. Only a test block will be performed to ensure correct placement of the catheter. At the end of the case in the post anaesthetic care unit (PACU) a bolus of 8-15 ml of Ropicavaine 0.2% will be administered through the epidural catheter, followed by an infusion of 5-15 ml/hr (based on clinical effect) of Ropivacaine 0.2% for 3 days. In TAP group bilateral catheters will be inserted in the transversus Abdominis Plane using an ultrasound guided approach at the end of the case, to avoid any interference with the surgical procedure. A 20 ml bolus of Ropivacaine 0.375% will be administered through each catheter, followed in the PACU by an infusion of 8 ml/hr of 0.2% Ropivacaine through each catheter for 3 days.
Sponsors
The Queen Elizabeth hospital
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
Elective abdominal surgery American society of anaesthesiologist(ASA) grade less then 4 Adequate English language skills
Exclusion criteria
Emergency surgery. Allergy to local anaesthetic. Pregnancy. On regular opioid medication prior to surgery. Mental handicap or psychiatric condition precluding adequate communication. Spinal cord disorder, bleeding disorder, infection on the back.
Outcome results
None listed