TAP block for laparoscopic appendicectomy in adults
Research type
Research Study
Full title
Ultrasound guided transversus abdominis plane (TAP) block for postoperative analgesia after laparoscopic appendicectomy in adults- a double blind randomised controlled trial
IRAS ID
139454
Contact name
Michael Silva
Contact email
Sponsor organisation
Oxford University Hospitals NHS Trust
Research summary
Appendicitis is one of the commonest abdominal emergencies. Often removal of the appendix (appendicectomy) is required which can be performed using a minimally invasive, Laparoscopic (keyhole), procedure. When compared to open resection laparoscopy reduces hospital stay, complications and improves return to normal activity. However, it is still associated with a significant amount of pain and discomfort. Analgesia is provided by a multimodal technique that invariably includes parenteral opioids. Opioids are associated with a number of side-effects including an increased incidence of nausea and vomiting, which can prolong recovery from surgery.
A significant component of pain after laparoscopic surgery arises from the abdominal wall. Transversus Abdominis Plane (TAP) block is a technique which numbs the nerves carrying pain sensation from the abdominal wall and provides effective and safe analgesia. A study by Niraj et al demonstrated reduced morphine consumption and an improvement in pain scales when TAP was utilised in open appendicectomies.There is currently no similar data for laparoscopic appendicectomy in adults. We believe ultrasound guided TAP blocks will reduce pain, morphine consumption, reduce the incidence of nausea and vomiting and enable earlier hospital discharge.
The study will be a double blind randomised controlled trial with patients undergoing emergency laparoscopic appendicectomy randomly allocated into two groups. The study group will receive bilateral TAP blocks followed by opioid analgesia when required. The control group will have local anaesthetic infiltrated around incision sites followed by opioid analgesia when required. Our aim is to ascertain which technique provides better post-operative pain relief.
?The study duration will be from induction of anaesthesia until medically fit for discharge from hospital.? No extra visits other than routinely required for the surgical procedure are expected. The study will be conducted at the John Radcliffe Hospital without need for external funding.
REC name
South Central - Oxford C Research Ethics Committee
REC reference
14/SC/1166
Date of REC Opinion
21 Oct 2014
REC opinion
Further Information Favourable Opinion