Clinical Trial: TAP Versus Thoracic Epidural in Major Abdominal Resections

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: Efficacy and Safety of Transversus Abdominis Plane Blocks Versus Thoracic Epidural Anesthesia in Patients Undergoing Major Abdominal Resections: A Prospective, Randomized Controlled Trial

Brief Summary: The purpose of this study is to compare two standard methods of pain control management used at Spectrum Health for patients undergoing major surgery. The two methods being compared are the thoracic epidural and the TAP block. The thoracic epidural method involves medication being given through a patient's back and the TAP block involves medication being given through a patient's abdomen (belly). The investigators will compare side effects experienced by the patients that take part in this study, including a change in blood pressure, as well as the patients' opinions about their pain management experience after surgery.

Detailed Summary:

The purpose of this study is to compare the clinical profiles of two currently acceptable analgesia techniques in terms of incidence of hypotension with subsequent fluid administration and pain control by evaluation of both objective and subjective data. The investigators will also compare any additional hospital costs associated with side effect management related to either analgesia method.

This study is a prospective, randomized, open-label trial. Patients who agree to participate and satisfy the inclusion/exclusion criteria will be randomized at the time of enrollment into one of two groups (thoracic epidural or TAP block) using a randomization tool created for the study.

Patients will undergo their scheduled surgery and receive the analgesic method to which they have been randomized. Both methods (thoracic epidural or TAP block) are performed routinely at Spectrum Health and are considered routine care.

Data collected will include medical history and demographics from the patient's medical record. Intraoperative data will include length of surgery, estimated surgical blood loss, complications, blood pressure and medication requirements. Postoperative data will include episodes of hypotension (defined as a systolic BP < 90), fluid requirement in first 24 hours and first 72 hours, pain scores, narcotic usage, return to bowel function (as defined by flatus), time to tolerating a soft or regular diet, and complications. Data will also be collected via a survey each study patient will complete for study purposes only.


Sponsor: Spectrum Health Hospitals

Current Primary Outcome: Hypotension [ Time Frame: First 24-72 hours postoperatively ]

The incidence of systolic blood pressure less than 90 mmHg and fluid requirements


Original Primary Outcome: Same as current

Current Secondary Outcome: Patient satisfaction relative to pain control and amount of additional narcotic usage [ Time Frame: Post operative day two during hospitalization ]

A short patient survey during the postoperative period which will collect information on pain management.


Original Secondary Outcome: Same as current

Information By: Spectrum Health Hospitals

Dates:
Date Received: May 13, 2014
Date Started: July 2014
Date Completion:
Last Updated: September 8, 2016
Last Verified: September 2016