{
  "abstract": "Background and objectives The transversus abdominis plane (TAP) block is the most widely used abdominal field block in colorectal surgery with a postoperative enhanced recovery pathway. We aimed to determine whether the laparoscopic-assisted and ultrasound-guided TAP (US-TAP) blocks provide superior pain relief compared with placebo. We separately investigated whether the laparoscopic-assisted technique was non-inferior to the ultrasound-guided technique in providing pain relief, with a non-inferiority margin of 10 mg morphine dose equivalents.Methods 340 patients undergoing elective minimally invasive colon surgery were randomly allocated to one of three groups: (1) US-TAP block, (2) laparoscopic-assisted TAP (L-TAP) block, or (3) placebo. Superiority and non-inferiority were tested for the primary outcome: 24-hour postoperative morphine equivalent consumption. Secondary outcomes, including patient-reported quality of recovery, were included in the superiority analysis.Results 127 patients were included in each block group and 86 in the placebo group. The US-TAP block was no different from placebo at −1.4 mg morphine (97.5% CI −6.8 to 4.0 mg; p=0.55). The L-TAP block was superior to placebo at −5.9 mg morphine (97.5% CI −11.3 to −0.5 mg; p=0.01) and non-inferior to the US-TAP block at −4.5 mg morphine (98.75% CI −10.0 to 1.1 mg).Conclusion The L-TAP block was superior to placebo and non-inferior to the US-TAP block. However, neither met our predetermined estimate of the minimal clinically important difference of 10 mg morphine.Trial registration number NCT04311099.",
  "authors": [
    {
      "affiliations": [
        "Department of Surgery, Copenhagen University Hospital - North Zealand, Hillerød, Denmark",
        "Department of Anaesthesiology, Copenhagen University Hospital - North Zealand, Hillerød, Denmark"
      ],
      "name": "Christopher Blom Salmonsen"
    },
    {
      "affiliations": [
        "North Zealand, Department of Anaesthesiology, Copenhagen University Hospital, Hillerød, Denmark",
        "Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark"
      ],
      "name": "Kai Henrik Wiborg Lange"
    },
    {
      "affiliations": [
        "Department of Surgery, Copenhagen University Hospital - North Zealand, Hillerød, Denmark",
        "Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark"
      ],
      "name": "Jakob Kleif"
    },
    {
      "affiliations": [
        "Department of Surgery, Esbjerg and Grindsted Hospital, Esbjerg, Denmark",
        "Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark"
      ],
      "name": "Rasmus Krøijer"
    },
    {
      "affiliations": [
        "Department of Surgery, Viborg Regional Hospital, Viborg, Denmark"
      ],
      "name": "Lea Bruun"
    },
    {
      "affiliations": [
        "Department of Surgery, Viborg Regional Hospital, Viborg, Denmark"
      ],
      "name": "Martynas Mikalonis"
    },
    {
      "affiliations": [
        "Department of Surgery, Viborg Regional Hospital, Viborg, Denmark"
      ],
      "name": "Peter Dalsgaard"
    },
    {
      "affiliations": [
        "Surgical Research Unit, Gødstrup Hospital, Herning, Denmark",
        "NIDO | Centre for Research and Education, Gødstrup Hospital, Herning, Denmark",
        "Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark"
      ],
      "name": "Karen Busk Hesseldal"
    },
    {
      "affiliations": [
        "Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark",
        "Department of Anaesthesiology and Intensive Care, Gødstrup Hospital, Herning, Denmark"
      ],
      "name": "Jon Emil Philip Olsson"
    },
    {
      "affiliations": [
        "Department of Surgery, Copenhagen University Hospital - North Zealand, Hillerød, Denmark",
        "Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark"
      ],
      "name": "Claus Anders Bertelsen"
    },
    {
      "affiliations": [],
      "name": "The OPMICS Study Group"
    }
  ],
  "title": "Transversus abdominis plane block in minimally invasive colon surgery: a multicenter three-arm randomized controlled superiority and non-inferiority clinical trial",
  "uid": "ac8ce4e1-606a-50e6-ab1f-bf534ef10564"
}