Efficacy of Transversus Abdominis Plane Block Versus Local Injection of Pain Medication
Status:
Completed
Trial end date:
2013-10-01
Target enrollment:
Participant gender:
Summary
The purpose of this study is to determine if there is a better method of administering pain
medication prior to minimally invasive gynecological surgery so that postoperative pain
and/or narcotic usage may be minimized. Currently, no standard of care exists regarding the
use of local pain medications in minimally invasive gynecological surgery and practices vary
widely among physicians, even within the same institution.
The two methods of preemptive pain medication that this study will be looking at is the
transversus abdominis plane (TAP) block and the local injection of pain medication at the
areas of the skin incisions. TAP block is a procedure performed by a specially trained pain
management anesthesiologist in which there is an injection of a local pain medication into
the abdominal wall, specifically in a space where the nerves that are responsible for
postoperative pain reside. This procedure blocks the ability of the nerves to sense pain and
has been found to be successful in decreasing postoperative pain in a number of procedures.
The local injection of pain medications at the incision sites has also been found to be
beneficial in decreasing postoperative pain. However, it is not known whether one method is
superior to the other in decreasing postoperative pain or if the combination of both is best.
Patients that chose to participate are randomly (by chance) assigned to one of three groups:
1) TAP block with pain medication and local injection of normal saline (water) at the
incision sites 2) TAP block with normal saline and local injection of pain medication at the
incision sites or 3) TAP block with pain medication and local injection of pain medication at
the port sites. These procedures are performed while the patient is asleep. Patients will be
asked to record their level of pain on a standardized pain scale at one hour, six hours, and
twenty-four hours after the surgery. All patients are provided with standard postoperative
pain medications as needed.
The hypothesis is that patients receiving both TAP block and local injection of pain
medication at the port sites will have less pain postoperatively and require a smaller amount
of narcotics than those that receive either the TAP block or local injection of pain
medication alone.