Evaluation of Postoperative Analgesic Efficacy of Transversus Abdominis Plane Block After Appendectomy: A Controlled Clinical Trial Study

determinaton of the analgesic effect of transversus abdominis plane block following appendectomy

A single-center, two-arm, parallel-group, randomized, active-controlled, double-blind clinical trial will be conducted at Imam Reza Hospital in Birjand, Iran. The target sample size is 60 patients, with a target of 30 patients per group. Patients will be assigned to either a TAP block with ropivacaine or intravenous pethidine using simple computer-generated randomization with equal allocation probabilities (1:1). Participants and data analysts will be blinded to group allocation.

Single-center, two-arm, parallel-group, randomized, active-controlled, double-blind clinical trial will be conducted at Imam Reza Hospital in Birjand, Iran

include: age over 15,asa score 1 and 2 exclude:perforation,appendicitis with hernia,bowel surgery,gyno surgery with appendectomy, age under 15

The intervention group will receive a single ultrasound-guided, right-sided lateral transversus abdominis plane (TAP) block administered by an anesthesiologist at the end of open appendectomy, before emergence from anesthesia. Twenty milliliters of 0.25% ropivacaine will be injected between the internal oblique and transversus abdominis muscles. The control group will receive 25 mg of intravenous pethidine before transfer to the recovery room. Rescue analgesia will be provided as needed in both groups according to the study protocol.

Pain intensity will be measured using the Numerical Rating Scale at 1, 2, 6, 12, and 24 hours after surgery. Nausea and vomiting, adverse events, time to the first request for analgesia, and analgesic consumption will be recorded during the first 24 hours. Rescue analgesia will be provided as needed in both groups according to the protocol

Randomization will be performed at the individual patient level using simple computer-generated randomization, with an equal probability of assignment to either the intervention or control group. No blocking or stratification will be used. Before participant recruitment, an independent researcher who is not involved in participant enrollment or intervention delivery will generate the allocation sequence using a computerized pseudorandom number generator. For each position in the sequence, the program will independently generate either code 1 or code 2 with equal probability. Allocation concealment will be maintained using sequentially numbered, opaque, sealed envelopes prepared according to the generated sequence by the independent researcher. Each envelope will contain one group assignment. After eligibility has been confirmed, written informed consent obtained, and baseline information recorded, each participant will receive the next sequential study number. The participant’s identifying details will be recorded on the corresponding envelope before it is opened. The envelope will then be opened by the anesthesiologist when the assigned intervention is due. Personnel responsible for participant enrollment will have no access to the allocation sequence or unopened assignments.

This study will be conducted as a double-blind trial, with participants and data analysts blinded to group allocation. Both groups will undergo general anesthesia. Participants in the intervention group will receive a TAP block at the end of surgery before emergence from anesthesia, while participants in the control group will receive intravenous pethidine before transfer to the recovery room. Participants will not be informed of their assigned intervention. The anesthesiologist administering the intervention will be aware of group allocation. Statistical analyses will be performed without disclosing the treatment identity of each group to the data analysts.