Postoperative analgesia is an important part of the anesthetic care. According to the recent studies, multimodal analgesia can provide better analgesia \& patient satisfaction with fewer side effect. For example, combining intravenous, intramuscular or oral analgesics with transversus abdominis plane (TAP) block or local anesthetic (LA) infiltration as the multimodal analgesia, can furnish a more effective pain control after the abdominal surgery. For abdominal surgery, both local infiltration and TAP block target on relieving somatic pain. Local anesthetic wound infiltration is easy to perform with low risk. As the advancement of ultrasound technology, performing the TAP block also becomes easier, safer and more accurate. But whether LA infiltration or TAP block is better for the multimodal analgesia regimen remains unclear. This study is to compare the postoperative pain score, opioid consumption, side effects, and quality of recovery between these two analgesic methods in patients undergoing abdominal surgery. The investigators hypothesized that TAP block may be more effective than LA infiltration as a part of the multimodal analgesia, and can improve the recovery after the abdominal surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
TRIPLE
Enrollment
108
bilateral ultrasound-guided transversus abdominis plane block, with 20 ml of 0.25% ropivacaine at each side after the induction of general anesthesia
local anesthetics infiltration at surgical wound with 20 ml of 0.5% ropivacaine before wound closure
postoperative analgesia with intravenous patient controlled analgesia with morphine
Taipei Medical University Hospital
Taipei, Taiwan, Taiwan
Pain Score (NRS: Numerical Rating Scale)
pain scores of the participants will be followed at postoperative 1, 6, 24, 48 hour (up to 48 hours). (NRS: from 0 to 10, 0 = no pain, 10 = the worst pain) The higher score idicates the worse outcome.
Time frame: postoperative 24 hour dynamic
Opioid Consumption
opioid consumption of the participants will be followed at postoperative 1, 6, 12, 24, 36, 48 hour (up to 48 hours).
Time frame: postoperative 48 hour
Sedation Scale
Time frame: postoperative 1, 6, 24, 48 hour
Nausea and Vomiting Categorical Score
Time frame: postoperative 1, 6, 24, 48 hour
Rescue Analgesic Use
Time frame: postoperative 1, 6, 12, 24, 36, 48 hour
Rescue Antiemetics Use
Time frame: postoperative 1, 6, 12, 24, 36, 48 hour
Time to the First Request of Analgesics
participants will be followed for the duration of hospital stay
Time frame: an expected average of 5 days
Pruritus
Time frame: postoperative 1, 6, 24, 48 hour
Quality of Recovery 40
Time frame: postoperative 48 hour
Heart Rate Variability
Time frame: preoperative, postoperative 1 hour and 1 day
Time to Flatus
participants will be followed for the duration of hospital stay
Time frame: an expected average of 5 days
Length of Hospital Stay
participants will be followed for the duration of hospital stay
Time frame: an expected average of 5 days
Number of Participants With Intervention-related Complication
participants will be followed for the duration of hospital stay
Time frame: an expected average of 5 days
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