Best timing for subcostal TAP plus rectus sheath block to reduce pain after laparoscopic gallbladder removal
Effect of Timing of Ultrasound-Guided Subcostal Transversus Abdominis Plane Block Combined With Rectus Sheath Block on Postoperative Pain in Laparoscopic Cholecystectomy: A Prospective Randomized Controlled Trial
This trial will test whether giving ultrasound-guided subcostal transversus abdominis plane (TAP) blocks combined with rectus sheath blocks before the incision or after surgery reduces pain for adults having elective laparoscopic gallbladder removal.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 96 (estimated) |
| Ages | 18 Years to 80 Years |
| Sex | All |
| Sponsor | Eulji University Hospital Academic / other |
| Locations | 1 site (Seoul) |
| Trial ID | NCT07440940 on ClinicalTrials.gov |
What this trial studies
This is a prospective, single-center, randomized controlled trial enrolling adults undergoing elective laparoscopic cholecystectomy who meet inclusion criteria. Participants are randomized 1:1 to receive combined ultrasound-guided subcostal TAP block and rectus sheath block either before skin incision or after completion of surgery, with standardized general anesthesia and postoperative analgesia for all. The primary outcome is postoperative pain intensity measured on a numerical rating scale at predefined time points; secondary outcomes include cumulative opioid consumption, incidence of postoperative nausea and vomiting, rescue analgesic needs, and recovery parameters. Block randomization with randomly permuted block sizes will be used to allocate participants and outcomes will be compared between timing groups.
Who should consider this trial
Good fit: Adults aged 18–80 scheduled for elective laparoscopic cholecystectomy with ASA physical status I–III who can provide informed consent are the ideal candidates.
Not a fit: Patients with abdominal wall infection or anatomical abnormalities at the injection site, allergy to study drugs, major neurologic/psychiatric disease, pregnancy or breastfeeding, planned single-port surgery, or ASA IV+ are excluded and unlikely to benefit from this protocol.
Why it matters
Potential benefit: If successful, this could reduce early postoperative pain and opioid use after laparoscopic cholecystectomy and speed recovery.
How similar studies have performed: Previous trials have shown that TAP and rectus sheath blocks can reduce postoperative pain and opioid use after abdominal surgery, but evidence about the optimal timing of combined blocks is limited and mixed.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Elective laparoscopic cholecystectomy * Adults aged 18 to 80 years * Ability to understand the study procedures and provide informed consent * American Society of Anesthesiologists (ASA) physical status I-III Exclusion Criteria: * Presence of significant pain unrelated to the target disease that may interfere with pain assessment * Known allergy or contraindication to study medications (ropivacaine, acetaminophen, nefopam, or pethidine) * Planned single-port laparoscopic cholecystectomy * American Society of Anesthesiologists (ASA) physical status IV or higher * Infection of the abdominal wall or skin at the injection site, or anatomical abnormalities of the abdominal wall * Major neurological, psychiatric, or systemic diseases that may affect pain perception, treatment response, or study evaluation * Requirement for postoperative mechanical ventilation * Pregnancy or breastfeeding * Considered unsuitable for the study by the investigator * Refusal to participate or inability to provide informed consent
Where this trial is running
Seoul
- Nowon Eulji University Hospital — Seoul, South Korea (Recruiting)
Study contacts
- Principal investigator: Hye-yeon Cho — Nowon Eulji University Hospital, Eulji University College of Medicine
- Study coordinator: Hye-Yeon Cho, MD
- Email: anesthesia_chy@eulji.ac.kr
- Phone: +82-2-970-8705
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.