Intraoperative TAP Block and Post-operative Pain Control for Minimally Invasive Hysterectomy
Status:
Not yet recruiting
Trial end date:
2024-05-31
Target enrollment:
Participant gender:
Summary
Modern postoperative pain management aims to optimizing pain relief while minimizing opiate
usage. While opiates are effective for pain relief, they result in common adverse effects
such as nausea, constipation, and urinary retention, and most importantly present a long-term
risk of abuse and dependency [1,2]. Commonly used approaches include non-opiate pain
medications such as acetominophen and non-steroidal anti-inflammatory agents, as well as
regional nerve blocks such as epidurals [3].
The transversus abdominis plane (TAP) block is a fascial plane block performed by injecting
local anesthetic into the plane superficial to the transversus abdominis muscle where the
anterior rami of the spinal nerves course to provide sensory innervation to the abdominal
wall. The injections are generally placed either subcostally or at the midaxillary line
bilaterally [4-6]. The TAP block has been shown to be effective in reducing pain scores and
opiate usage in some randomized studies but not others in patients undergoing various
abdominal surgeries [7]. There is great variation in method of administration, sites
injected, and local anesthetics used, which may in part account for the heterogeneity of
trial results.