Timing of Subcostal TAPB Combined With Rectus Sheath Block for Postoperative Pain After Laparoscopic Cholecystectomy

NCT07440940 | Recruiting

• 1 other identifier: 2026-01-026
• Study Type: interventional
• Target: 96
• Locations: 1 country
• Sites: 1

Brief Summary

This prospective randomized controlled trial aims to evaluate whether the timing of ultrasound-guided subcostal transversus abdominis plane (TAP) block combined with rectus sheath block (RSB) affects postoperative pain in patients undergoing laparoscopic cholecystectomy. Participants will be randomly assigned to receive the combined regional blocks either before surgical incision or after completion of surgery. The primary outcome is postoperative pain intensity measured using a numerical rating scale. Secondary outcomes include opioid consumption, incidence of postoperative nausea and vomiting, and other recovery parameters. The results of this study may help optimize the timing of abdominal wall blocks to improve postoperative analgesia and recovery following laparoscopic cholecystectomy.

Conditions

Postoperative Pain; Laparoscopic Cholecystectomy

Keywords

Laparoscopic Cholecystectomy; Transversus Abdominis Plane Block; Rectus Sheath Block; Postoperative pain

Outcome Measures

Primary Outcomes (1)

• Maximum postoperative pain intensity within 24 hours

  The highest postoperative pain intensity measured using an 11-point numeric rating scale (NRS; 0 = no pain, 10 = worst pain imaginable) during the first 24 hours after surgery, assessed at 1, 6, 12, and 24 hours postoperatively.

  Within 24 hours after surgery

Secondary Outcomes (3)

• Maximum postoperative pain intensity during post-anesthesia care unit stay

  During the post-anesthesia care unit stay

• Cumulative rescue opioid consumption within 24 hours

  Within 24 hours after surgery

• Incidence of postoperative nausea and vomiting

  Within 24 hours after surgery

Study Arms (2)

Pre-incisional Block Group

EXPERIMENTAL

Participants receive ultrasound-guided subcostal transversus abdominis plane (TAP) block combined with rectus sheath block (RSB) after induction of general anesthesia and before surgical incision.

Procedure: Ultrasound-guided subcostal TAP block combined with rectus sheath block

Postoperative Block Group

EXPERIMENTAL

Participants receive ultrasound-guided subcostal transversus abdominis plane (TAP) block combined with rectus sheath block (RSB) after completion of surgery and before emergence from anesthesia.

Procedure: Ultrasound-guided subcostal TAP block combined with rectus sheath block

Interventions

Ultrasound-guided subcostal TAP block combined with rectus sheath block PROCEDURE

Ultrasound-guided right subcostal transversus abdominis plane (TAP) block combined with bilateral rectus sheath block (RSB) is performed under sterile conditions using local anesthetic for postoperative analgesia.

Postoperative Block Group; Pre-incisional Block Group

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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

You may not qualify if:

• 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

Sponsors & Collaborators

• Eulji University Hospital: lead

Study Sites (1)

Nowon Eulji University Hospital

Seoul, 01830, South Korea

RECRUITING

MeSH Terms

Conditions

Pain, Postoperative

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Study Officials

• Hye-yeon Cho

  Nowon Eulji University Hospital, Eulji University College of Medicine

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Hye-Yeon Cho, MD

CONTACT

+82-2-970-8705; anesthesia_chy@eulji.ac.kr

Soojeong Kang, MD

CONTACT

+82-2-970-8705; 20260034@eulji.ac.kr

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: Participants and outcome assessors will be blinded to group allocation. The anesthesiologist performing the block will not be blinded due to the nature of the intervention.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant professor

Model Details: Participants will be randomly assigned in a 1:1 ratio to receive the combined ultrasound-guided subcostal TAP block and rectus sheath block either before surgical incision or after completion of surgery.

Study Record Dates

• First Submitted: February 22, 2026
• First Posted: February 27, 2026
• Study Start: February 23, 2026
• Primary Completion (Estimated): January 15, 2027
• Study Completion (Estimated): January 15, 2027
• Last Updated: February 27, 2026

Record last verified: 2026-02

Locations

KR (1)