Adding a bilateral ultrasound-guided TAP block to spinal anesthesia with intrathecal morphine for cesarean delivery
Effect of Bilateral Ultrasound-Guided Transversus Abdominis Plane Block on Quality of Recovery in Cesarean Delivery Patients Receiving Intrathecal Morphine: A Prospective Observational Cohort Study
We will test whether giving a bilateral ultrasound-guided transversus abdominis plane (TAP) block in addition to standard spinal anesthesia with intrathecal morphine helps women recover better after an elective cesarean delivery.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 150 (estimated) |
| Ages | 18 Years to 45 Years |
| Sex | Female |
| Sponsor | Samsun University Academic / other |
| Locations | 1 site (Samsun, Samsun) |
| Trial ID | NCT07145619 on ClinicalTrials.gov |
What this trial studies
This is a prospective, assessor-blinded observational cohort at a single center where all participants receive spinal anesthesia with intrathecal morphine as routine care. Patients are managed in two groups: one group receives an additional bilateral ultrasound-guided TAP block at the end of surgery and the control group does not. Both groups receive standardized postoperative analgesia via intravenous patient-controlled analgesia (IV PCA), and outcomes are collected prospectively with the assessor blinded to group allocation. The primary outcome is the Obstetric Quality of Recovery-10 (ObsQoR-10) score at 24 hours, with secondary outcomes including pain scores, time to first breastfeeding, mobilization, discharge, and total opioid use.
Who should consider this trial
Good fit: Women aged 18–45 with singleton pregnancies scheduled for elective lower-segment cesarean delivery under spinal anesthesia who can give informed consent and use IV PCA are the intended participants.
Not a fit: Patients with contraindications to spinal anesthesia or TAP block, chronic opioid use, urgent/emergency cesarean delivery, BMI >40 kg/m², severe preeclampsia or major psychiatric or cognitive impairment are unlikely to be eligible or to experience benefit from this approach.
Why it matters
Potential benefit: If successful, adding a TAP block could reduce pain and opioid needs and speed recovery, breastfeeding, and mobilization after cesarean delivery.
How similar studies have performed: Previous randomized trials and meta-analyses have shown that TAP blocks can reduce somatic postoperative pain and opioid consumption after cesarean delivery, but benefits are mixed when intrathecal morphine is already used.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Female patients aged 18-45 years * Singleton pregnancy * ASA physical status II-III * Scheduled elective lower segment cesarean delivery under spinal anesthesia with intrathecal morphine (ITM) as standard care * Able to understand study procedures, provide written informed consent, and reliably use IV PCA * Able to complete ObsQoR-10-T assessments (with trained assistance if needed) Exclusion Criteria: * Contraindication to spinal anesthesia or TAP block (e.g., infection at injection site, coagulopathy, allergy to local anesthetics) * Chronic opioid use or opioid/alfa-2 agonist intolerance * Severe preeclampsia, HELLP syndrome, significant hepatic or renal impairment * Urgent or emergent cesarean section (Category 1) * Cognitive impairment or communication difficulty preventing accurate assessment * Prior major abdominal surgery (other than previous cesarean delivery) * Body mass index (BMI) \> 40 kg/m² * Major psychiatric illness (e.g., major depressive disorder, generalized anxiety disorder, psychosis) that may affect pain perception or quality of recovery
Where this trial is running
Samsun, Samsun
- Samsun University Training and Research Hospital — Samsun, Samsun, Turkey (Türkiye) (Recruiting)
Study contacts
- Principal investigator: Mehmet Gökhan Taflan, MD — Samsun Education and Research Hospital
- Study coordinator: Mehmet Gökhan Taflan, MD
- Email: drmehmettaflan@gmail.com
- Phone: +905352114070
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.