Laparoscopic Colectomy, Pain, Postoperative
Conditions
Keywords
Transversus Abdominis Plane (TAP) Block, Local Anesthetic Infiltrations
Brief summary
The purpose of this study is to compare the postoperative pain, the time needed and other clinical outcomes in patients who, during laparoscopic colectomy, will be injected with a local anesthetic (Ropivacaine) through an ultrasound guided technique performed by the anaesthesiologist or throught a laparoscopic assisted technique performed by the surgeon
Interventions
PROCEDURElaparoscopic-assisted Transversus Abdominis Plane (TAP) block
The anterior axillary line is used as landmarks. After insertion of the optic trocar, the peritoneum is visualized. A 14 Gauge needle is inserted 2 cm cranially respect the taken landmark through the skin until the penetration of the internal and external oblique fascias, identified as sudden lowering of resistance. A solution of 15 ml of Ropivacaine (0.2%) is then injected. The procedure is performed then 2 cm caudal to the first landmark on the same side. The procedure is than repeated identically on the contralateral side.
PROCEDUREultrasound-assisted Transversus Abdominis Plane (TAP) block
Whilst the patient is in the supine position, a high frequency ultrasound probe is placed transverse to the abdominal wall between the costal margin and iliac crest. The needle is introduced in plane of the ultrasound probe directly under the probe and advanced until it reaches the plane between the internal oblique and transversus abdominis muscles. Then 15 ml of local anaesthetic solution is injected. The needle is than retracted until its tip is positioned in the fascial plane between the internal and the external oblique muscles and a second bolus of 15 ml of local anaesthetic is injected. The procedure is than repeated identically on the contralateral side.
DRUGRopivacaine
a solution of 15 ml of Ropivacaine (0.2%) is injected for the treatment of post-operative pain after minimally invasive surgery (TAP block)
Sponsors
Davide La Regina
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Caregiver)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients candidates to laparoscopic colorectal surgery * Signed informed consent
Exclusion criteria
* Age \< 18 years old * Pregnancy * Allergy to local anaesthetics * Spinal or epidural analgesia * Acute inflammatory abdominal pathologies * Chronic pain syndrome * Contraindications to nonsteroidal anti-inflammatory drugs (NSAIDS)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Opioids consumption | 24 hours from surgery | Opioid consumption measured in morphine milligram equivalents (MME) per day |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Opioid consumption within the first 48 hours after the operation | 48 hours from surgery | Opioid consumption measured in morphine milligram equivalents (MME) per day |
| postoperative pain | at 3, 6, 12, 24 hours from surgery | Postoperative pain on the visual analogue scale (VAS) at 3, 6, 12, 24 hours. This visual analogue scale measures the subjective pain: patients indicate a position along a continuous line between two end-points to specify their level of pain. Absence of pain is represented by 0 while 10 corresponds to the maximum of pain. |
| length of hospital stay | during hospitalization,approximately 6 days | number of days the participant is being hospitalized |
| Time required to perform the (Transversus Abdominis Plane) TAP block | during procedure | — |
Countries
Switzerland
Outcome results
None listed