Do adjuncts in TAP blocks prolong analgesia post caesarean section?

• Research type

  Research Study

• Full title

  Analgesic efficacy of ultrasound guided transversus abdominis plane block as part of a multimodal analgesic regime for post elective caesarean section pain – a comparative double-blinded placebo controlled trial using plain bupivacaine, bupivacaine with adrenaline and bupivacaine with dexamethasone.

• IRAS ID

  6449

• Sponsor organisation

  Portsmouth Hospitals NHS Trust

• Eudract number

  2008-006080-36

• ISRCTN Number

  N/A

• Clinicaltrials.gov Identifier

  N/A

• Research summary

  Many women still experience considerable pain after caesarean section despite optimal traditional pain relief regimens. Good pain relief (analgesia) after caesarean section is important. It helps women bond with and breast feed their babies, get out of bed sooner after their operation (reducing the risk of blood clots) and improves patient experience.Transversus abdominis plane (TAP) blocks have recently been described in the anaesthetic literature. A TAP block is a local anaesthetic injection used to numb the tummy wall and give pain relief after abdominal operations. There has been only one published randomised controlled trial looking at the role of TAP blocks for pain relief after caesarean section. The aims of this study are two fold. We would like to confirm that TAP blocks are safe and effective way of improving pain relief for patients having caesarean sections. We would also like to explore the potential benefits of adding other drugs (adrenaline and dexamethasone) to the local anaesthetic mixture. This may improve the quality of and extend the duration of the blocks. If proven to be effective, TAP blocks may become a standard part of the pain relieving regime used for caesarean sections.All participants will receive the standard spinal anaesthetic and analgesic regime of St Mary's Hospital, Portsmouth. In addition, they will receive a TAP block with a placebo solution or one of the three treatment solutions. They will be randomly allocated into one of the four groups. Pain scores will be assessed at four different time periods. Success of the TAP block will be assessed to detect block failure in an active treatment group. All participants will be recruited from the elective caesarean section patients of St Mary's Hospital, Portsmouth. The study will be completed at 48 hours for all participants. No external funding is required for this research.

• REC name

  London - Brighton & Sussex Research Ethics Committee

• REC reference

  08/H1107/192

• Date of REC Opinion

  23 Dec 2008

• REC opinion

  Further Information Favourable Opinion