TAP Block for Pain After Cesarean Section

Overseen By Stephen Wood, MD

Age: 18+

Sex: Female

Trial Phase: Academic

Sponsor: University of Calgary

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 1

Duration: 1 day

80 Participants Needed

Trial Summary

What is the purpose of this trial?

The purpose of this research study is to evaluate whether or not adding a Transversus Abdominis Plane Block (TAP block) improves pain control for patients having a cesarean section. A TAP block is a type of nerve block where at the end of the surgery an injection of a long acting local anesthetic is made into the abdominal wall. In studies in patient's having other abdominal surgeries this has reduced the amount of narcotics patients need for pain control. This may also led to patients being more active after surgery and maybe spending less time in hospital.

Research Team

Stephen Wood, MD

Principal Investigator

University of Calgary

Eligibility Criteria

This trial is for individuals undergoing a cesarean section who are interested in better pain management post-surgery. The study is open to those willing to receive a TAP block, which involves an injection of local anesthetic into the abdominal wall at surgery's end.

Inclusion Criteria

I am having a planned C-section with regional anesthesia at any stage of pregnancy.

ASA status II to III

Exclusion Criteria

I cannot take NSAIDs after giving birth.

I am scheduled for surgery with a vertical cut on my abdomen.

I am scheduled for a Cesarean Hysterectomy.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants undergo a cesarean section with or without a Transversus Abdominis Plane Block (TAP block) administered by the surgeon

1 day

1 visit (in-person)

Post-operative Monitoring

Participants are monitored for pain levels and opioid use post-surgery

48 hours

Follow-up

Participants are monitored for safety and effectiveness after treatment

1-3 days

Treatment Details

Interventions

• Transversus Abdominis Plane Block

Trial Overview The study tests if adding a Transversus Abdominis Plane Block with bupivacaine (a long-acting local anesthetic) can improve pain control after cesarean sections, potentially reducing the need for narcotics and shortening hospital stays.

Participant Groups

Group I: Surgeon-administered Transversus Abdominis Plane Block (TAP block) Experimental Treatment 1 Intervention

After uterine closure, the anterior abdominal wall on the contralateral side to the surgeon is elevated and retracted laterally by an assistant. The bowel and uterus is retracted using the surgeon's non-dominant hand, with or without a sponge. Under direct visualization, a blunted spinal needle is inserted lateral to the rectus muscle to avoid injury to inferior epigastric blood vessels. The needle is then gently advanced through the transversus abdominis fascia into the TAP plane, identified at loss of resistance, or 'a pop'. After aspiration to confirm no accidental placement of the needle intravascularly, local anaesthetic is infiltrated into the transverse abdominis plane through the parietal peritoneum by the surgeon at a prespecified dose of 0.25% bupivicaine 0.25 mL/kg (approximately 20cc). This is repeated on the contralateral side, after which closure of the fascia, subcutaneous tissue, and skin were performed.

Group II: No TAP block Active Control 1 Intervention

A sham procedure will not be performed but the patient will be unaware of whether or not an injection was done.

Who Is Running the Clinical Trial?

University of Calgary

Lead Sponsor

Trials

827

Recruited

902,000+