TAP Block Versus ESP Block in Patients Undergoing Elective Cesarean Section: a Randomized Controlled Trial

NCT07292662 | Recruiting

• 1 other identifier: 6334/AO/25
• Study Type: interventional
• Target: 90
• Locations: 1 country
• Sites: 1

Brief Summary

This study is comparing two types of pain relief techniques-TAP block and ESP block-for women having an elective cesarean section. Both techniques involve injecting local anesthetic under ultrasound guidance to numb nerves and reduce pain after surgery. The TAP block mainly relieves pain in the abdominal wall, while the ESP block may reduce both abdominal wall and deeper, organ-related pain. The main goal is to see if there's a difference in pain at rest six hours after surgery. The study will also look at pain at later time points, the amount of opioid medication needed, how quickly women can walk, and when they start breastfeeding. A total of 156 women will be randomly assigned to receive one of the two blocks after standard spinal anesthesia. Pain will be measured using a simple 0-10 scale at 6, 12, and 24 hours, both at rest and during movement. The study follows strict ethical rules, ensures patient privacy, and all results-whether positive or negative-will be shared to help improve pain management after cesarean delivery.

Conditions

Cesarean Delivery; Regional Anesthesia Block

Keywords

ESP block; TAP block; cesarean section

Outcome Measures

Primary Outcomes (1)

• Pain at Rest at 6 hours

  Pain measured at Rest with Numeric Rating Scale (minimun 0- maximum 10) with 0 meaning no pain and 10 high pain

  6 hours after end of surgery

Secondary Outcomes (9)

• Pain at Rest at 12 hours

  12 hours after end of surgery

• Pain at Rest at 24 hours

  24 hours after end of surgery

• Pain at Movement at 6 hours

  6 hours after end of surgery

• Pain at Movement at 12 hours

  12 hours after end of surgery

• Pain at Movement at 24 hours

  24 hours after end of surgery

Study Arms (2)

TAP block

ACTIVE COMPARATOR

Patients will undergo preoperative bilateral TAP block with ropivacaine 0.375% 20 mL per side (total 40 mL)

Procedure: TAP block

ESP block

EXPERIMENTAL

Patients will undergo preoperative bilateral ESP block with ropivacaine 0.375% 20 mL per side (total 40 mL)

Procedure: ESP block

Interventions

TAP block PROCEDURE

TAP block will be performed with with ropivacaine 0.375% 20 mL per side (total 40 mL)

TAP block

ESP block PROCEDURE

ESP block will be performed with ropivacaine 0.375% 20 mL per side (total 40 mL)

ESP block

Eligibility Criteria

• Age: 18 Years - 45 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Age between 18 and 45 years
• Elective cesarean section
• Ability to provide informed consent

You may not qualify if:

• Allergy to any of the drugs used in the study
• Heart disease with impaired cardiac function
• Stage III or higher kidney failure
• Coagulation disorders (platelets \<100,000/μL or INR \>1.5) or severe liver disease
• Degenerative central nervous system diseases or peripheral neuropathies
• Previous uterine surgery (e.g., myomectomy)
• Previous cesarean section
• Pre-pregnancy weight \<55 kg

Sponsors & Collaborators

• University of Padova: lead

Study Sites (1)

University Hospital of Padua

Padova, 35127, Italy

RECRUITING

Central Study Contacts

Lorenzo Alfonsi, MD

CONTACT

+390498213090; lorenzo.alfonsi@aopd.veneto.it

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Masking Details: Outcome assessor and investigator will be blind of the procedure as each patient will be associated with an unique ID. Patients and patient care provider could not be blind given the nature of the procedure
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: September 12, 2025
• First Posted: December 18, 2025
• Study Start: January 7, 2026
• Primary Completion (Estimated): October 1, 2027
• Study Completion (Estimated): October 1, 2027
• Last Updated: April 13, 2026

Record last verified: 2026-04

Locations

IT (1)