Optimal Perioperative Pain Control in Minimally Invasive Abdominal Cancer Surgery (LapTAP)

September 15, 2025 updated by: Casey Allen, MD, Allegheny Singer Research Institute (also known as Allegheny Health Network Research Institute)

Evaluating Optimal Perioperative Pain Management: A Prospective Randomized Control Trial of Laparoscopic Transversus Abdominis Plane Block With Local Anesthetic, Laparoscopic Transversus Abdominis Plane Block Alone, and Local Anesthetic Alone in Minimally Invasive Oncologic Surgery

This is a research study to evaluate the effectiveness of 3 different types of routine pain management regimens used during clinically indicated, minimally invasive oncologic (cancer) surgery. This project is considered "Research" and participation is voluntary. Upon enrollment in this study, the research team will collect data from the patient's medical records. The patient will undergo all of the normal testing and procedures required pre-operatively (standard of care). The study team will then randomly assign the patient (like a flip of a coin) to one of three different study arms for pain management during surgery:

  1. Laparoscopic Transversus Abdominis Plane Block (LapTAP) with Local Anesthetic (LA)
  2. Laparoscopic Transversus Abdominis Plane Block (LapTAP) only
  3. Local Anesthetic (LA) only The patient will receive standard pre- and post-operative care according to clinical guidelines (routine care). The study team will collect information from the patient's medical record for the first 24 hours after their surgery and upon discharge. This information will include pain scores, amount of medication required, any side effects the patient may have experienced, and satisfaction with pain control. Participation in the study will end upon discharge from the hospital.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Traditional pain management strategies have heavily relied on the use of Local Anesthesia (LA). Laparoscopic Transversus Abdominis Plane block (LapTAP) has emerged as a new approach for postoperative pain control following minimally invasive surgery, promising enhanced pain control in comparison with traditional approaches. Preliminary investigations into LapTAP have shown promise, yet there remains a significant gap in comparative effectiveness research, especially juxtaposed against the more traditional LA. We propose a comprehensive three-arm superiority trial evaluating LapTAP in conjunction with LA, LapTAP alone, and LA alone. We intend to scrutinize the efficacy of each modality in managing postoperative pain specific to minimally invasive oncologic surgery. Findings from this trial will be used to refine clinical protocols, improve patient outcomes, and potentially standardize care in postoperative pain management for minimally invasive oncologic procedures.

Study Type

Interventional

Enrollment (Estimated)

48

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • United States
    • Pennsylvania
      • Pittsburgh, Pennsylvania, United States, 15224
        • Recruiting
        • AHN West Penn Hospital
        • Contact:
        • Contact:
        • Principal Investigator:
          • Casey J Allen, MD
        • Sub-Investigator:
          • Joseph Edward, MD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Male and female patients age ≥ 18 - 89
  2. Patients scheduled for elective (clinically indicated) hepatic, gastric, biliary, pancreatic, gynecologic, colorectal, other GI Minimally invasive oncologic surgery.
  3. Patients who have provided informed consent to participate in the study.
  4. Patients with an American Society of Anesthesiologists (ASA) physical status classification of I, II, or III.
  5. Patients undergoing procedures anticipated to last more than 1 hour but less than 8 hours.
  6. Patients able to understand and self-report pain using the designated pain Visual Analog Scale

Exclusion Criteria:

  1. Patients age less than 18 or ≥ 90
  2. Pre-existing hepatic dysfunction, cirrhosis
  3. Patients with an ASA classification of IV or higher.
  4. Patients with chronic pain disorders or on long-term opioid or analgesic therapy.
  5. Patients with known contraindications to the study drugs or procedures (e.g., allergy to LA or contraindications to LapTAP).
  6. Patients with cognitive impairments or psychiatric conditions that could interfere with pain assessment or understanding of informed consent.
  7. Patients unable to understand the language in which consent and study-related information are provided (The study and the study-related information will be in the English Language)..
  8. Patients who have undergone major surgery within the last 6 months.
  9. Female patients who are pregnant.
  10. Patients currently enrolled in another clinical trial that might interfere with the outcome measures of this study.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Laparoscopic Transversus Abdominis Plane Block with Local Anesthetic
Patient would be receiving Laparoscopic Transversus Abdominis Plane block in addition to Local Anesthetic per standard of care.
Procedure: Local Anesthesia
For local anesthetic administration at port sites, 30 mL of 0.1% ropivacaine is injected around the umbilical port site following the completion of the primary surgical procedure. Additionally, 5 mL of 0.1% ropivacaine is injected around each additional port site to ensure effective local anesthesia.
Procedure: Laparoscopic Transversus Abdominis Plane block
Surgeon will place 18 gauge needle into the fascial plane between the internal oblique and transversus abdominis muscles. Once the needle is accurately positioned surgeon will inject 15 mL of 0.1% ropivacaine slowly. This procedure is performed bilaterally to ensure comprehensive analgesia. The total volume utilized for the LapTAP block is 30 mL of 0.1% ropivacaine.
Active Comparator: Laparoscopic Transversus Abdominis Plane block only
Patient would be receiving Laparoscopic Transversus Abdominis Plane block without Local Anesthetic per standard of care.
Procedure: Laparoscopic Transversus Abdominis Plane block
Surgeon will place 18 gauge needle into the fascial plane between the internal oblique and transversus abdominis muscles. Once the needle is accurately positioned surgeon will inject 15 mL of 0.1% ropivacaine slowly. This procedure is performed bilaterally to ensure comprehensive analgesia. The total volume utilized for the LapTAP block is 30 mL of 0.1% ropivacaine.
Active Comparator: Local Anesthetic only
Patient would be receiving Local Anesthetic per standard of care.
Procedure: Local Anesthesia
For local anesthetic administration at port sites, 30 mL of 0.1% ropivacaine is injected around the umbilical port site following the completion of the primary surgical procedure. Additionally, 5 mL of 0.1% ropivacaine is injected around each additional port site to ensure effective local anesthesia.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain Score
Time Frame: Hourly, starting 1 hour post surgery for 24 hours, then at time of hospital discharge (on average 1 week)
Pain will be measured in the post anesthesia care unit (PACU) using Visual Analog Scale. Pain will be scored from zero to ten, with zero being no pain at all and ten being unbearable pain.
Hourly, starting 1 hour post surgery for 24 hours, then at time of hospital discharge (on average 1 week)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Opioid Consumption
Time Frame: up to 24 hours post surgery
Opioid consumption (milligrams) within the first 24 hours post-surgery (standardize with Morphine equivalence).
up to 24 hours post surgery
Recovery Analgesic Time
Time Frame: up to 24 hours post surgery
Time to first rescue analgesic request
up to 24 hours post surgery
Adverse Event(s) Frequency
Time Frame: immediately post surgery up through discharge (on average of 1 week)
Frequency of any adverse events related to interventions
immediately post surgery up through discharge (on average of 1 week)
Adverse Event(s) Severity
Time Frame: immediately post surgery up through discharge (on average of 1 week)
Severity of any adverse events related to interventions
immediately post surgery up through discharge (on average of 1 week)
Patient Satisfaction with Pain Management
Time Frame: At discharge (on average of 1 week)
Will gauge patient perceptions of pain control and overall satisfaction with their treatment with a standardized Visual Analog Scale utilizing a zero to ten scale, with zero being completely dissatisfied and ten being completely satisfied.
At discharge (on average of 1 week)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Allegheny Singer Research Institute (also known as Allegheny Health Network Research Institute)

Investigators

  • Principal Investigator: Casey Allen, MD, Allegheny Health Network

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

February 5, 2025

Primary Completion (Estimated)

June 1, 2026

Study Completion (Estimated)

December 1, 2026

Study Registration Dates

First Submitted

November 12, 2024

First Submitted That Met QC Criteria

December 9, 2024

First Posted (Actual)

December 13, 2024

Study Record Updates

Last Update Posted (Estimated)

September 18, 2025

Last Update Submitted That Met QC Criteria

September 15, 2025

Last Verified

September 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • LapTAP

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

It is not necessary for the scope of the study to share IPD.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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