Effectiveness of Combined Fascial Plane Blocks for Postoperative Pain in Gynecologic Oncology Surgery

NCT07312825 | Completed

• 1 other identifier: FASIALBLOCKJinekoOnkoAnj
• Study Type: observational
• Target: 94
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this prospective observational study is to compare the effectiveness of different postoperative analgesic techniques in patients undergoing major abdominal surgery for gynecologic oncology. The main question is whether the combination of TAP block with Quadratus Lumborum Block (QLB) or Rectus Sheath Block (RSB) provides superior pain relief compared to TAP block alone. All blocks were performed as part of routine clinical anesthesia practice according to the attending anesthesiologist's judgment. No randomization, allocation, or study-directed intervention was performed. Patients were classified into three groups based on the block type they received during standard care: Group 1: TAP Block Only Group 2: TAP + QLB Combination Group 3: TAP + RSB Combination Postoperative data, including pain scores (VAS), opioid consumption, sedation level, heart rate, blood pressure, nausea/vomiting, and length of hospital stay, were collected prospectively. The study aims to determine which block combination provides the best postoperative pain control and recovery profile in patients undergoing gynecologic oncology surgery.

Conditions

Gynecologic Cancers; Postoperative Pain Management

Keywords

Fascial Plane Blocks for postoperative Analgesia (TAP Block, QLB, RSB); Gynecologic Oncology Surgery; Postoperative Analgesia

Outcome Measures

Primary Outcomes (1)

• Total Morphine Consumption

  Total amount of morphine (mg) administered to the patient within the first 24 hours after surgery for postoperative analgesia. Morphine use will be recorded from patient-controlled analgesia (PCA) device data or medical records.

  Within 24 hours after surgery

Secondary Outcomes (7)

• Postoperative pain intensity (VAS score)

  0-24 hours postoperatively; VAS score (0-10)

• Incidence of postoperative nausea and vomiting

  Time Frame: 0-24 hours postoperatively

• Time to first gas or stool passage

  From the end of surgery up to postoperative 72 hours

• Time to mobilization

  From the end of surgery up to postoperative 72 hours

• Time to oral intake

  From the end of surgery up to postoperative 72 hours

Other Outcomes (1)

• 1.Sedation Level (Ramsey Sedation Score)

  0-24 hours after surgery

Study Arms (3)

Group 1: TAP Block Only Group

Patients who received only Transversus Abdominis Plane (TAP) block as part of routine anesthesia practice. No additional regional block was performed.

Other: Group 1:The Transversus Abdominis Plane (TAP) block

Group 2: TAP + QLB Combination

Patients who received both TAP block and Quadratus Lumborum Block (QLB) as part of standard clinical anesthesia management.

Other: Group 2: TAP Block + Quadratus Lumborum Block (QLB)

Group 3: TAP + RSB Combination

Patients who received both TAP block and Rectus Sheath Block (RSB) as part of standard clinical anesthesia management.

Other: Group 3: TAP Block + Rectus Sheath Block (RSB)

Interventions

Group 1:The Transversus Abdominis Plane (TAP) block OTHER

Patients who received only Transversus Abdominis Plane (TAP) block as part of routine clinical anesthesia practice. No study-assigned intervention or randomization was performed. Data were collected prospectively from standard anesthesia records.

Group 1: TAP Block Only Group

Group 2: TAP Block + Quadratus Lumborum Block (QLB) OTHER

Patients who received TAP block combined with Quadratus Lumborum Block (QLB) during routine anesthesia management. This block combination was chosen by the attending anesthesiologist as part of standard care, not assigned by the study.

Group 2: TAP + QLB Combination

Group 3: TAP Block + Rectus Sheath Block (RSB) OTHER

Patients who received TAP block combined with Rectus Sheath Block (RSB) as part of routine anesthesia practice. The block technique was performed according to clinical judgment, not as part of a study intervention.

Group 3: TAP + RSB Combination

Eligibility Criteria

• Age: 18 Years+
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

The study population consists of adult female patients who are undergoing elective major abdominal surgery due to gynecologic cancer (e.g., endometrial cancer, ovarian cancer, debulking surgery). Participants will be aged 18 years and older, and only those with ASA I-IV status who are deemed fit for surgery will be included.

You may qualify if:

• Age 18 years or older.
• ASA physical status I-IV.
• Scheduled for major gynecologic oncology surgery (endometrial cancer, ovarian tumor, or cytoreductive surgery).
• Undergoing general anesthesia.
• Planned postoperative abdominal fascial plane block for pain management (TAP, TAP + QLB, or TAP + RSB).
• Able to provide written informed consent.

You may not qualify if:

• Refusal to participate or inability to provide informed consent.
• Emergency surgery.
• Known allergy or contraindication to local anesthetics.
• Infection at the block site.
• Coagulopathy or anticoagulant use that contraindicates regional anesthesia.
• Pre-existing chronic pain conditions or chronic opioid use.
• Severe hepatic or renal insufficiency.
• Cognitive impairment that prevents reliable pain assessment.

Sponsors & Collaborators

• Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital: lead

Study Sites (1)

Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital

Ankara, Turkey (Türkiye)

Location

Related Publications (3)

• Yu S, Wen Y, Lin J, Yang J, He Y, Zuo Y. Combined rectus sheath block with transverse abdominis plane block by one puncture for analgesia after laparoscopic upper abdominal surgery: a randomized controlled prospective study. BMC Anesthesiol. 2024 Feb 9;24(1):58. doi: 10.1186/s12871-024-02444-6.

  PMID: 38336613 RESULT

• Zhu JL, Wang XT, Gong J, Sun HB, Zhao XQ, Gao W. The combination of transversus abdominis plane block and rectus sheath block reduced postoperative pain after splenectomy: a randomized trial. BMC Anesthesiol. 2020 Jan 23;20(1):22. doi: 10.1186/s12871-020-0941-1.

  PMID: 31973700 RESULT

• Akerman M, Pejcic N, Velickovic I. A Review of the Quadratus Lumborum Block and ERAS. Front Med (Lausanne). 2018 Feb 26;5:44. doi: 10.3389/fmed.2018.00044. eCollection 2018.

  PMID: 29536008 RESULT

MeSH Terms

Interventions

Dental Occlusion

Intervention Hierarchy (Ancestors)

Dentistry; Dental Physiological Phenomena; Digestive System and Oral Physiological Phenomena

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Doctor of Anesthesiology

Study Record Dates

• First Submitted: April 7, 2025
• First Posted: December 31, 2025
• Study Start: January 1, 2024
• Primary Completion: January 1, 2025
• Study Completion: March 20, 2025
• Last Updated: December 31, 2025

Record last verified: 2025-04

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL

Locations

TU (1)