Colorectal Cancer, Enhanced Recovery After Surgery, Rectus Sheath Block, Robotic Surgery, Transversus Abdominis Plane Block
Conditions
Keywords
colorectal cancer, robotic colectomy, enhanced recovery after surgery, transversus abdominis plane block, rectus sheath block
Brief summary
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.
Detailed description
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.
Interventions
DRUGRopivacaine
TAP+RS block using ropivacaine
DRUGSaline
TAP+RS block with saline
Sponsors
Tri-Service General Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Patients scheduled for elective robotic colorectal cancer surgery for the first time
Exclusion criteria
* Age \< 18 years or age \> 80 years * Allergic to any medication in the protocol * Infection over the injection site * Chronic pain history * Severe hepatic or renal insufficiency * Pregnancy * Emergency surgery * Refusal to join the study
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Visual Analogue Scale at Resting | Postoperative 48 hours |
| Visual Analogue Scale at Movement | Postoperative 48 hours |
| Postoperative Opioid Consumption | Postoperative 48 hours |
Secondary
| Measure | Time frame |
|---|---|
| Postoperative Adverse Event | From surgery until hospital discharge |
| Time to First Ambulation | From surgery until hospital discharge |
| Time to First Flatus | From surgery until hospital discharge |
| Hospital Stay | At hospital discharge |
Countries
Taiwan
Contacts
CONTACTWei-Cheng Tseng, MD
Outcome results
None listed