Colorectal Disorders Clinical Trial
Official title:
Comparison of Analgesic Efficacy of Local Wound Infiltration Plus Transversus Abdominis Plane Block and Local Wound Infiltration Only After Laparoscopic Colorectal Resection: a Randomized, Double-blind, Non-inferiority Trial
The TAP block is typically performed either with ultrasound guidance (TAP-US) or laparoscopic
visualization (TAP-LAP): comparison between these two technics showed no differences in pain
control and use of opioid analgesics.
The investigators hypothesize that WI is non-inferior to WI + TAP-block with respect to
postoperative pain.
In colorectal surgery, laparoscopy and enhanced recovery after surgery (ERAS) programs have
significantly improved the short-term outcomes (1). Although the laparoscopic approach
reduces pain and recovery time, post-operative pain, nausea and vomiting still represent an
issue. In order to reduce opioid related side effects, such as postoperative nausea and
vomiting (PONV), constipation and prolonged post-operative ileus, non-opioid based multimodal
analgesia have been recently introduced. Although epidural analgesia has gained good success,
it does not seem to offer any additional clinical benefits to patients undergoing
laparoscopic colorectal surgery compared to alternative analgesic technique within an ERAS
program. Both local wound infiltration (WI) and TAP block are common techniques in multimodal
postoperative pain treatment, and their association allows to achieve pain control despite a
reduced use of opioid analgesics. Furthermore, in a recent single-blind prospective study TAP
block resulted superior to wound infiltration alone. The TAP block is typically performed
either with ultrasound guidance (TAP-US) or laparoscopic visualization (TAP-LAP): comparison
between these two technics showed no differences in pain control and use of opioid
analgesics.
The aim of this study is to compare WI + TAP-LAP versus WI alone. The investigators
hypothesize that WI is non-inferior to WI + TAP-block with respect to postoperative pain.
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