Fixed-Mass Different Volumes Bupivacaine TAP Block After Cesarean

NCT07616180 | Not Yet Recruiting Phase 4 DMC

• 1 other identifier: MD-185-2023
• Study Type: interventional
• Target: 50
• Locations: 0 countries
• Sites: N/A

Brief Summary

Cesarean section is commonly associated with moderate to severe postoperative pain, which may delay mobilisation, impair breastfeeding, and affect mother-infant bonding. Although opioids, NSAIDs, and neuraxial techniques are commonly used for post-cesarean analgesia, their side effects have encouraged the use of peripheral nerve blocks such as the transversus abdominis plane block. The TAP block is a fascial plane block that provides analgesia by depositing local anaesthetic between the internal oblique and transversus abdominis muscles. Its efficacy after cesarean section has been demonstrated, particularly when long-acting intrathecal opioids are not used. However, the optimal local anaesthetic volume and dose remain unclear. Since the TAP block depends on adequate spread of local anaesthetic, larger volumes may improve analgesic coverage, but increasing the dose may raise the risk of systemic toxicity. Therefore, this study investigates whether using the same fixed mass of bupivacaine in two different volumes affects the analgesic efficacy of TAP block after cesarean section, hypothesising that the larger volume may provide better postoperative analgesia.

Conditions

TAP Block; Caesarean Section; Postoperative Pain

Outcome Measures

Primary Outcomes (1)

• total postoperative morphine consumption

  first 24 hours postoperatively

Study Arms (2)

Fixed-mass, high-volume bupivacaine TAP block

EXPERIMENTAL

Participants will receive a bilateral ultrasound-guided TAP block using 150 mg of plain bupivacaine, diluted to a total volume of 60 mL, injected as 30 mL per side.

Drug: Bupivacaine

Fixed-mass, low-volume bupivacaine TAP block

EXPERIMENTAL

Participants will receive a bilateral ultrasound-guided TAP block using 150 mg of plain bupivacaine, diluted to a total volume of 120 mL, injected as 60 mL per side.

Drug: Bupivacaine

Interventions

Bupivacaine DRUG

Ultrasound-guided bilateral transversus abdominis plane block using 150 mg plain bupivacaine after cesarean section. The same total bupivacaine dose will be administered in two different volumes: 60 mL total volume, 30 mL per side

Fixed-mass, high-volume bupivacaine TAP block

Eligibility Criteria

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

You may qualify if:

• full-term parturients,
• aged \> 18 years
• ASA physical status II
• patients who are scheduled for elective CS with Pfannenstiel incisions under spinal anaesthesia.

You may not qualify if:

• Parturients with contraindications to spinal anaesthesia,
• Having a scar or infection at the site of the block
• BMI \> 35 Kg/m2,
• on chronic use of pain medications,
• Refusing to participate.

Sponsors & Collaborators

• Cairo University: lead

MeSH Terms

Conditions

Pain, Postoperative

Interventions

Bupivacaine

Condition Hierarchy (Ancestors)

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

Intervention Hierarchy (Ancestors)

Anilides; Amides; Organic Chemicals; Aniline Compounds; Amines

Central Study Contacts

Abeer Ahmed, MD

CONTACT

+201005244590; abeer_ahmed@kasralainy.edu.eg

Study Design

• Study Type: interventional
• Phase: phase 4
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: May 16, 2026
• First Posted: June 1, 2026
• Study Start: June 6, 2026
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): October 1, 2026
• Last Updated: June 1, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will not share