Surgery Clinical Trial
Official title:
Efficacy and Safety of Transversus Abdominis Plane Blocks Versus Thoracic Epidural Anesthesia in Patients Undergoing Major Abdominal Resections: A Prospective, Randomized Controlled Trial
The purpose of this study is to compare two standard methods of pain control management used at Spectrum Health for patients undergoing major surgery. The two methods being compared are the thoracic epidural and the TAP block. The thoracic epidural method involves medication being given through a patient's back and the TAP block involves medication being given through a patient's abdomen (belly). The investigators will compare side effects experienced by the patients that take part in this study, including a change in blood pressure, as well as the patients' opinions about their pain management experience after surgery.
The purpose of this study is to compare the clinical profiles of two currently acceptable
analgesia techniques in terms of incidence of hypotension with subsequent fluid
administration and pain control by evaluation of both objective and subjective data. The
investigators will also compare any additional hospital costs associated with side effect
management related to either analgesia method.
This study is a prospective, randomized, open-label trial. Patients who agree to participate
and satisfy the inclusion/exclusion criteria will be randomized at the time of enrollment
into one of two groups (thoracic epidural or TAP block) using a randomization tool created
for the study.
Patients will undergo their scheduled surgery and receive the analgesic method to which they
have been randomized. Both methods (thoracic epidural or TAP block) are performed routinely
at Spectrum Health and are considered routine care.
Data collected will include medical history and demographics from the patient's medical
record. Intraoperative data will include length of surgery, estimated surgical blood loss,
complications, blood pressure and medication requirements. Postoperative data will include
episodes of hypotension (defined as a systolic BP < 90), fluid requirement in first 24 hours
and first 72 hours, pain scores, narcotic usage, return to bowel function (as defined by
flatus), time to tolerating a soft or regular diet, and complications. Data will also be
collected via a survey each study patient will complete for study purposes only.
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