Ignite Creation Date:
2024-05-11 @ 8:31 AM
Last Modification Date:
2024-10-26 @ 3:29 PM
Study NCT ID:
NCT06406959
Status:
RECRUITING
Last Update Posted:
2024-05-09
First Post:
2024-04-20
Brief Title:
The Effect of Preemptive Regional Anesthesia TAP-block on Acute and Chronic Pain After Transabdominal Preperitoneal Inguinal Hernia Repair TAPP
Sponsor:
Pirogov Russian National Research Medical University
Organization:
Pirogov Russian National Research Medical University
Study Overview
Official Title:
The Effect of Preemptive Regional Anesthesia TAP-block on Acute and Chronic Pain After Transabdominal Preperitoneal Inguinal Hernia Repair TAPP - a Randomized Controlled Trial
Status:
RECRUITING
Status Verified Date:
2024-05
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
ERA-TAPP
Brief Summary:
The study is devoted to the impact of preemptive regional Transversus abdominal plane block on the postoperative acute and chronic pain after elective Transabdominal preperitoneal TAPP inguinal hernia repair
Detailed Description:
Inguinal hernia repair is one of the most common elective interventions in general surgery Approximately 20 million inguinal hernia repairs are performed worldwide every year Laparo-endoscopic techniques provide faster recovery times lower chronic pain risk and are cost effective compared to open one
Nevertheless laparoscopic inguinal hernia repair can result in moderate to severe pain in the early postoperative period interfering the time of returning to normal activity in a substantial quantity of patients To reduce pain and to accelerate recovery local and regional anesthetics has been successfully implemented into the daily routine of abdominal surgeries
Recent systematic reviews have shown that TAP block can reduce analgetic consumption and acute pain scores after inguinal hernia repair However most included studies were conducted on patients with open hernia surgery or total extra peritoneal TEP inguinal hernia repair Some studies showed the benefit of TAP block for early pain control following TAPP Most of them were retrospective some conducted with exclusion of obese or comorbid patients some in mixed groups without separating patients with TAPP and TEP
Thus the evidence of TAP block efficiency prior to hernia repair in TAPP technique are of low quality
Chronic postoperative inguinal pain CPIP develops in up to 6 of patients after TAPP Several studies have found that intense acute postoperative pain is a risk factor for CPIP after IHR The investigators hypothesize that preemptive TAP block temporary stops nociception and central sensitization from the surgical site thus reduce acute postoperative pain that theoretically provoke reducing the incidence of CPIP following IHR Two studies suggest that TAP block may influence the incidence of CPIP after TAPP Considering the retrospective study design of both and the insufficient sample size further randomized clinical trials are mandatory to estimate this hypothesis
The aim of our study is to explore the possibilities of reducing acute and chronic pain after TAPP via implementation TAP block
The sample size was calculated based on the randomized controlled trial data of patients after TEP IHR where postoperative VAS score at 4 h on coughing was 4715 in the preemptive local anesthesia group and 6119 in the control group A sample size of 39 patients was required for each subgroup total78 patients with a type I error rate α005 and type II error rate β01
Nevertheless laparoscopic inguinal hernia repair can result in moderate to severe pain in the early postoperative period interfering the time of returning to normal activity in a substantial quantity of patients To reduce pain and to accelerate recovery local and regional anesthetics has been successfully implemented into the daily routine of abdominal surgeries
Recent systematic reviews have shown that TAP block can reduce analgetic consumption and acute pain scores after inguinal hernia repair However most included studies were conducted on patients with open hernia surgery or total extra peritoneal TEP inguinal hernia repair Some studies showed the benefit of TAP block for early pain control following TAPP Most of them were retrospective some conducted with exclusion of obese or comorbid patients some in mixed groups without separating patients with TAPP and TEP
Thus the evidence of TAP block efficiency prior to hernia repair in TAPP technique are of low quality
Chronic postoperative inguinal pain CPIP develops in up to 6 of patients after TAPP Several studies have found that intense acute postoperative pain is a risk factor for CPIP after IHR The investigators hypothesize that preemptive TAP block temporary stops nociception and central sensitization from the surgical site thus reduce acute postoperative pain that theoretically provoke reducing the incidence of CPIP following IHR Two studies suggest that TAP block may influence the incidence of CPIP after TAPP Considering the retrospective study design of both and the insufficient sample size further randomized clinical trials are mandatory to estimate this hypothesis
The aim of our study is to explore the possibilities of reducing acute and chronic pain after TAPP via implementation TAP block
The sample size was calculated based on the randomized controlled trial data of patients after TEP IHR where postoperative VAS score at 4 h on coughing was 4715 in the preemptive local anesthesia group and 6119 in the control group A sample size of 39 patients was required for each subgroup total78 patients with a type I error rate α005 and type II error rate β01
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None