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Patients receiving bilateral subcostal TAP block.

Patients not receiving bilateral subcostal TAP block.

At the end of surgery, an anesthesiologist will perform bilateral subcostal TAP block with 0.375% ropivacaine 15ml at each site under ultrasound guidance.

Ultrasound guided subcostal transversus abdominis plane block (TAPB)

0.375% ropivacaine is injected to the transversus abdominis plane via 21G 100 mm stimulator needle (Echoplex®, Vygon, Ecouen, France)

Ropivacaine 0.75% Injectable Solution

21G 100 mm stimulator needle (Echoplex®, Vygon, Ecouen, France)

Hojin Lee, MD

This prospective, randomized, single blinded study is designed to evaluate the postoperative analgesic efficacy of the ultrasound-guided subcostal transversus abdominis plane block in gastric cancer patients undergoing laparoscopic gastrectomy. We hypothesize that US guided subcostal TAP block with ropivacaine can significantly reduce postoperative opioid comparison in patients with laparoscopic gastrectomy.

Adult patients undergoing elective laparoscopic gastrectomy are randomly allocated to receive subcostal TAP block (n=56) or not (n=56), in addition to a standard postoperative analgesic regimen comprising of IV fentanyl-based patient-controlled analgesia (PCA) and NSAIDs as required. At the end of surgery, the TAP group patients will receive bilateral subcostal TAP block under ultrasound guidance with 15ml of 0.375% ropivacaine bilaterally. Each patient was assessed by a blinded investigator at 6, 12, 24, and 48 h postoperatively. The primary outcome is total fentanyl consumption at 24 h after surgery.

A prospective randomized double-blinded study

We plan to perform TAPB in patients under general anesthesia. Physicians not involved in this study will investigate the outcomes.

Postoperative Analgesic Effect of Subcostal TAPB for Laparoscopic Gastrectomy

Ultrasound-guided Subcostal Transversus Abdominis Plane Block in Gastric Cancer Patients Undergoing Laparoscopic Gastrectomy: A Randomized Controlled Double-blinded Study

postoperative cumulative fentanyl consumption (mcg)

11-pointed NRS pain score at resting/coughing NRS (0-10): 0, "no pain"; 10, "worst pain imaginable"

Incidence of postoperative nausea and vomiting, dizziness, sedation, respiratory depression (%)

Overall postoperative rescue of nonopoioid(ketorolac, nefopam) analgesic requirement

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Postoperative Analgesic Effect of Subcostal TAPB for Laparoscopic Gastrectomy	NCT04138901	Postoperative P...	Ultrasound guid... Ropivacaine 0.7... 21G 100 mm stim...	18 Years - 80 Years	Seoul National University Hospital
Postoperative Analgesic Effect of Subcostal TAPB for Laparoscopic Gastrectomy	NCT04138901	Postoperative P...	Ultrasound guid... Ropivacaine 0.7... 21G 100 mm stim...	18 Years - 80 Years	Seoul National University Hospital
Postoperative Analgesic Effect of Subcostal TAPB for Laparoscopic Gastrectomy	NCT04138901	Postoperative P...	Ultrasound guid... Ropivacaine 0.7... 21G 100 mm stim...	18 Years - 80 Years	Seoul National University Hospital

Spots Global Cancer Trial Database for 21g 100 mm stimulator needle (echoplex®, vygon, ecouen, france)