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NCT Number: NCT06853782

Comparison of Postoperative Analgesic Efficacy of TAP Block and TFP Block in Patients Undergoing Abdominal Hysterectomy

Total abdominal hysterectomy is one of the most commonly performed surgeries in women and is known to cause significant pain in especially early postoperative period. The goal of this clinical trial is to compare analgesic efficiacy of TAP block, which is well established by studies in hysterectomy surgeries, and TFP block, a relatively new block with good analgesic effect when used for lower abdominal surgeries, in patients undergoing abdominal hysterectomy surgery.The main parameters to compare the analgesic efficiacy of TAP and TFP blocks are;

1. Pain scores in motion 2. Opioid consumption

Researchers will apply the lateral TAP block and TFP block, prepare the postoperative analgesic treatment regimen and record the patients' analgesic consumption, make ward visits and ask patients about their pain intensity and check for opioid consumption and associated side effects, block-related complications, mobilization, length of hospital stay, and patient satisfaction in patients undergoing elective total abdominal hysterectomy surgery.

Participants will score the pain they feel in motion with certain pain scales.Participants will also respond to the researchers' questions for other parameters in study.

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Key information

Conditions

Hysterectomy, Benign Uterine Diseases Abdominal Pain Abdominal Pain (AP) Neurologic Manifestations Pain Pathological Conditions, Signs and Symptoms Signs and Symptoms Signs and Symptoms, Digestive

Age range

18 year and older

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

Hacettepe University Hospital

Ankara, Turkey, 06230, Turkey (Türkiye)

About this study

Total abdominal hysterectomy is a commonly performed surgical procedure in women that involves the surgical removal of the uterus and is known to cause significant pain, especially during the early postoperative period.

This study aims to prospectively compare the effects of lateral TAP block and TFP block in patients undergoing elective total abdominal hysterectomy with Pfannenstiel incision under general anesthesia for benign uterine neoplasms in a randomized controlled manner.

The TAP block is a fascial plane block targeting the trunkal T6-T12/L1 nerves located between the internal oblique and transversus abdominis muscles and is an effective regional anesthesia method for abdominal surgeries. In patients undergoing total abdominal hysterectomy, TAP block significantly reduces opioid consumption during the postoperative period and results in marked decreases in pain scores at rest and during movement without causing side effects.

The TFP block is a regional analgesia method used in lower abdominal surgeries targeting the branches of the trunkal T12-L1 nerves, located between the transversus abdominis muscle and transversalis fascia. While the TAP block covers dermatomes from T6-L1, the TFP block targets dermatomes T12-L1. A significant difference from the TAP block is that the TFP block provides effective analgesia in areas innervated by the lateral cutaneous branches emerging from the L1 dermatome that TAP block may not fully cover.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • ASA scores of 1-2
  • Adults aged 18+ years
  • Diagnosed with benign uterine neoplasms and will undergo elective total abdominal hysterectomy via Pfannenstiel incision under general anesthesia
  • Agreed to participate in the study will be included.

Exclusion criteria

  • Patients with known
  • Neuropathy
  • Renal failure
  • Hepatic failure
  • Coagulopathy
  • Skin infection at the site of intervention
  • Allergy to local anesthetics
  • BMI > 35 kg/m²
  • Hysterectomy surgery extended due to malignancy or multiple surgeries during the same hospitalization
  • Emergency surgeries
  • ASA scores of 3-4
  • Emergency surgery
  • Patients who do not consent to participate in the study will be excluded.

Treatment and study plan

High Frequency Linear Probe (GE Logic e R7 Ultrasonography Device, USA)

Device

A high frequency linear probe (GE Logic e R7 Ultrasonography Device, USA) device will be used while blocking in both groups.

Primary outcomes

  1. Numeric Rating Scale

    Time frame: Postoperative 30th minute, 1st, 2nd, 12th and 24th hours

    Postoperative pain assessment will be performed by a researcher at 30th minutes,1st, 2nd, 12th and 24th hours after the block, using the Numerical Rating Scale (NRS) for pain in movement. Patients will be blinded to the groups they participate in and asked to rate their pain on a scale from 0 to 10, where 0 means no pain and 10 represents the worst pain they can imagine.

Secondary outcomes

  1. Tramadol Consumption

    Time frame: Postoperative 0-6th, 6-12th, 12-24th hours

    Tramadol consumption (between 0-6, 6-12, 12-24 hours) will be assessed by a patient controlled analgesia (PCA) device.

    Additionally, in patients receiving rescue tramadol, the amount of tramadol required will be evaluated by reviewing the patient's daily medication order records.

  2. Rescue Tramadol Need

    Time frame: Postoperative 0-24th hours

    The need for rescue tramadol (Present/Absent), will be assessed by reviewing the patient's daily medication order records.

  3. Adverse Reactions

    Time frame: Postoperative 24th hour

    Opioid associated side effects such as nausea, vomiting, constipation, pruritis, urinary retention, respiratory depression and block related complications will be assessed.

  4. Patient Satisfaction

    Time frame: Postoperative 24th hour

    Patient satisfaction will be assessed by asking patients to choose one of the following options regarding their postoperative comfort: very satisfied, satisfied, neutral, dissatisfied, or very dissatisfied.

  5. Early Mobilization

    Time frame: Postoperative 24th hour

    Early mobilization will be assessed based on whether the patient started to walk within the first 24 hours postoperatively.

  6. Duration of Postoperative Hospital Stay

    Time frame: Postoperative 7th day

    The duration of the postoperative hospital stay will be assessed by checking the operation day and discharge day in the hospital records.

Sponsors and collaborators

Lead sponsor

Hacettepe University

Other

Registry information

Official study title

Comparison of Postoperative Analgesic Efficacy of Transversus Abdominis Plane (TAP) Block and Transversalis Fascia Plane (TFP) Block in Patients Undergoing Elective Total Abdominal Hysterectomy

Important dates

Study start
2023
Primary completion
2023
Study completion
2023
First posted
Mar 3, 2025
Registry last updated
Jan 6, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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