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Completed

NCT Number: NCT07312825

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

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.

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Key information

Conditions

Gynecologic Cancers Postoperative Pain Management

Age range

18 year and older

Sex eligibility

Female

Study type

Observational

Primary location

Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital

Ankara, Turkey (Türkiye)

About this study

This study is a prospective observational research designed to evaluate the postoperative analgesic effectiveness of different combinations of fascial plane blocks in patients undergoing gynecologic oncology surgery.

All blocks (Transversus Abdominis Plane [TAP] block, Quadratus Lumborum Block [QLB], and Rectus Sheath Block [RSB]) were performed as part of routine clinical anesthesia practice according to the attending anesthesiologist's preference.

No intervention, randomization, or protocol-directed procedure was applied for research purposes. After data collection, patients were classified into three groups based on the block type they had received in standard care:

TAP block only

TAP + QLB combination

TAP + RSB combination

The study prospectively compared postoperative pain scores (VAS), opioid consumption, time to mobilization, bowel function recovery, and length of hospital stay among these groups to determine the most effective analgesic strategy within routine practice.

This observational design reflects real-world anesthesia management and does not involve any experimental or interventional component.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • 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.

Exclusion criteria

  • 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.

Treatment and study plan

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 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 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.

Primary outcomes

  1. Total Morphine Consumption

    Time frame: Within 24 hours after surgery

    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.

Secondary outcomes

  1. Postoperative pain intensity (VAS score)

    Time frame: 0-24 hours postoperatively; VAS score (0-10)

    Pain intensity will be evaluated using the Visual Analog Scale (VAS; 0 = no pain, 10 = worst pain) at 0 min, 15 min, 2 hr, 6 hr, 12 hr, and 24 hr postoperatively.

  2. Incidence of postoperative nausea and vomiting

    Time frame: Time Frame: 0-24 hours postoperatively

    Number of patients experiencing postoperative nausea and/or vomiting within the first 24 hours.

  3. Time to first gas or stool passage

    Time frame: From the end of surgery up to postoperative 72 hours

    Time from the end of surgery to the first postoperative bowel movement or passage of gas.

  4. Time to mobilization

    Time frame: From the end of surgery up to postoperative 72 hours

    Time from the end of surgery to the first postoperative ambulation.

  5. Time to oral intake

    Time frame: From the end of surgery up to postoperative 72 hours

    Time from the end of surgery to the first postoperative oral feeding

  6. Length of hospital stay

    Time frame: From surgery to hospital discharge (up to 10 days) Unit of Measure:Days

    Total duration of hospitalization after surgery.

  7. Intensive care unit (ICU) length of stay

    Time frame: From surgery to hospital discharge (up to 3 days) Unit of Measure: Days

    Total duration of postoperative stay in the intensive care unit.

Other outcomes

  1. 1.Sedation Level (Ramsey Sedation Score)

    Time frame: 0-24 hours after surgery

    Sedation level evaluated using the Ramsey Sedation Scale at multiple postoperative time points.

Sponsors and collaborators

Lead sponsor

Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital

Other

Registry information

Official study title

Postoperative Analgesic Efficacy of Combined Fascial Plane Blocks After Gynecologic Oncologic Surgery

Important dates

Study start
2024
Primary completion
2025
Study completion
2025
First posted
Dec 31, 2025
Registry last updated
Dec 31, 2025

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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