Transversus Abdominis Plane and Rectus Sheath Block for Robotic Colectomy

Impact of Transversus Abdominis Plane Block Combined With Rectus Sheath Block on Postoperative Pain Management in Patients Undergoing Elective Robotic Colectomy

This study aimed to evaluate the impact of ultrasound-guided bilateral transversus abdominis plane block combined with rectus sheath block on postoperative pain and recovery after robotic colectomy under an enhanced recovery after surgery (ERAS) protocol.

Study Overview

• Status: Not yet recruiting
• Conditions: Colorectal Cancer; Robotic Surgery; Enhanced Recovery After Surgery; Transversus Abdominis Plane Block; Rectus Sheath Block
• Intervention / Treatment: Drug: Ropivacaine; Drug: Saline

Detailed Description

Postoperative pain remains an important concern after robotic colectomy despite the implementation of enhanced recovery after surgery (ERAS) protocols. Although robotic colectomy is associated with smaller incisions and faster recovery than conventional open surgery, postoperative pain may still impair early ambulation, gastrointestinal recovery, and patient satisfaction. Multimodal analgesia strategies, including acetaminophen and nonsteroidal anti-inflammatory drugs, are commonly used in ERAS pathways to reduce opioid consumption and opioid-related adverse effects. However, postoperative pain during movement and opioid requirements remain clinically relevant issues.

Ultrasound-guided transversus abdominis plane (TAP) block has been reported to reduce postoperative pain and opioid consumption after colorectal surgery. In addition, rectus sheath block (RSB) may provide further analgesic benefit for midline abdominal incision pain. Nevertheless, the additional clinical benefit of combining TAP block and RSB in patients undergoing robotic colectomy within an established ERAS pathway has not been fully investigated.

This study aimed to evaluate the impact of ultrasound-guided bilateral TAP block combined with RSB on postoperative pain and recovery following robotic colectomy. Additionally, we investigated the influence of TAP block combined with RSB on postoperative opioid consumption, postoperative nausea and vomiting, early ambulation, gastrointestinal recovery, and length of hospital stay after robotic colectomy under ERAS management.

• Study Type: Interventional
• Enrollment (Estimated): 90
• Phase: Phase 4

Contacts and Locations

• Study Contact: Name: Wei-Cheng Tseng, MD; Phone Number: 24159 886-2-8792-3311; Email: ndmc_wechern@yahoo.com.tw

Study Locations

• Taiwan
  • Taipei, Taiwan
    • Tri-Service General Hospital
    • Contact: Wei-Cheng Tseng, MD; Phone Number: 24159 886-2-8792-3311; Email: ndmc_wechern@yahoo.com.tw

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Patients scheduled for elective robotic colorectal cancer surgery for the first time

Exclusion Criteria:

• Age < 18 years or age > 80 years
• Allergic to any medication in the protocol
• Infection over the injection site
• Chronic pain history
• Severe hepatic or renal insufficiency
• Pregnancy
• Emergency surgery
• Refusal to join the study

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: TAP+RSB-R group; TAP+RS block with ropivacaine and standard analgesic care	Drug: Ropivacaine; TAP+RS block using ropivacaine
Placebo Comparator: TAP+RSB-S group; TAP+RS block with saline and standard analgesic care	Drug: Saline; TAP+RS block with saline

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Visual Analogue Scale at Resting	Postoperative 48 hours
Visual Analogue Scale at Movement	Postoperative 48 hours
Postoperative Opioid Consumption	Postoperative 48 hours

Secondary Outcome Measures

Outcome Measure	Time Frame
Postoperative Adverse Event	From surgery until hospital discharge
Time to First Ambulation	From surgery until hospital discharge
Time to First Flatus	From surgery until hospital discharge
Hospital Stay	At hospital discharge

Collaborators and Investigators

• Sponsor: Tri-Service General Hospital

Publications and helpful links

General Publications

• Yang R, Wang J, Shi DW, Niu Y, Zhou XD, Liu Y, Xu GH. The Efficiency of Multipoint Rectus Sheath Block Based on Incision Location in Laparoscopic-Assisted Colorectal Surgery: A Randomized Clinical Trial. Dis Colon Rectum. 2023 Dec 1;66(12):1578-1586. doi: 10.1097/DCR.0000000000002895. Epub 2023 Jun 28.
• Liu KY, Lu YJ, Lin YC, Wei PL, Kang YN. Transversus abdominis plane block for laparoscopic colorectal surgery: A meta-analysis of randomised controlled trials. Int J Surg. 2022 Aug;104:106825. doi: 10.1016/j.ijsu.2022.106825. Epub 2022 Aug 8.
• Viderman D, Aubakirova M, Abdildin YG. Transversus Abdominis Plane Block in Colorectal Surgery: A Meta-Analysis. Front Med (Lausanne). 2022 Feb 23;8:802039. doi: 10.3389/fmed.2021.802039. eCollection 2021.
• Liu L, Xie YH, Zhang W, Chai XQ. Effect of Transversus Abdominis Plane Block on Postoperative Pain after Colorectal Surgery: A Meta-Analysis of Randomized Controlled Trials. Med Princ Pract. 2018;27(2):158-165. doi: 10.1159/000487323. Epub 2018 Feb 1.
• Hain E, Maggiori L, Prost A la Denise J, Panis Y. Transversus abdominis plane (TAP) block in laparoscopic colorectal surgery improves postoperative pain management: a meta-analysis. Colorectal Dis. 2018 Apr;20(4):279-287. doi: 10.1111/codi.14037.

Study record dates

Study Major Dates

• Study Start (Estimated): June 1, 2026
• Primary Completion (Estimated): March 31, 2028
• Study Completion (Estimated): March 31, 2028

Study Registration Dates

• First Submitted: May 24, 2026
• First Submitted That Met QC Criteria: May 30, 2026
• First Posted (Actual): June 3, 2026

Study Record Updates

• Last Update Posted (Actual): June 3, 2026
• Last Update Submitted That Met QC Criteria: May 30, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: colorectal cancer; transversus abdominis plane block; enhanced recovery after surgery; rectus sheath block; robotic colectomy
• Additional Relevant MeSH Terms: Neoplasms by Site; Neoplasms; Intestinal Diseases; Gastrointestinal Neoplasms; Digestive System Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Intestinal Neoplasms; Rectal Diseases; Colonic Diseases; Colorectal Neoplasms; Organic Chemicals; Anilides; Amides; Aniline Compounds; Amines; Inorganic Chemicals; Chlorine Compounds; Sodium Compounds; Chlorides; Hydrochloric Acid; Ropivacaine; Sodium Chloride
• Other Study ID Numbers: C202605053

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: There is no plan to share

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