Trial results comparing transversus abdominis plane (TAP) block with epidural anesthesia for pain management in colorectal surgery were posted on ClinicalTrials.gov on 2026-01-28. The study indicated that TAP Block-Exparel led to a mean post-operative narcotic use of 54.64 morphine milligram equivalents (MME) on Day 0, compared to 80.20 MME for continuous epidural analgesia in one measurement.
Background
Colorectal cancer surgery often involves significant abdominal incisions, typically resulting in considerable post-operative pain. Effective pain management is crucial for patient recovery, early mobilization, and minimizing the risk of opioid-related side effects. Traditional methods include epidural analgesia, which provides regional pain relief but can have associated complications. Transversus Abdominis Plane (TAP) blocks offer an alternative regional anesthetic technique, aiming to provide somatic analgesia to the anterior abdominal wall.
Trial design
This completed study, without a specified phase, enrolled 200 participants undergoing elective colorectal surgery. The conditions investigated included Colon Cancer, Rectal Cancer, and Colonic Diverticulosis. The primary outcome measured was the Numeric Pain Score (NPS) for perioperative pain. Participants were randomized to receive either continuous epidural analgesia or a TAP Block-Exparel for pain management.
Key results
Key measurements from the trial included post-operative pain scores, overall benefits of analgesia, and patient use of narcotic analgesia:
- Post-operative Mean Numeric Pain Scale:
- For the Continuous Epidural Analgesia group, the mean score was 2.12 (Standard Deviation 1.44) units on a scale.
- For the TAP Block- Exparel group, the mean score was 2.32 (Standard Deviation 1.44) units on a scale.
- Overall Benefits of Analgesia Score (OBAS):
- The Continuous Epidural Analgesia group had a mean score of 0.48 (Standard Deviation 0.52) units on a scale.
- The TAP Block- Exparel group had a mean score of 0.37 (Standard Deviation 0.31) units on a scale.
- Patient Use of Narcotic Analgesia Post-op Day 0:
- The Continuous Epidural Analgesia group used a mean of 80.20 Morphine milligram equivalents.
- The TAP Block- Exparel group used a mean of 54.64 Morphine milligram equivalents.
- Patient Use of Narcotic Analgesia Post-operative Day 0 (second measurement):
- The Continuous Epidural Analgesia group used a mean of 27.55 Morphine milligram equivalents.
- The TAP Block- Exparel group used a mean of 54.64 Morphine milligram equivalents.
- Patient Use of Narcotic Analgesia Post-operative Day 1:
- The Continuous Epidural Analgesia group used a mean of 71 Morphine milligram equivalents.
- The TAP Block- Exparel group used a mean of 13.34 Morphine milligram equivalents.
- Patient Use of Narcotic Analgesia Post-operative Day 3:
- The Continuous Epidural Analgesia group used a mean of 0.34 Morphine milligram equivalents.
- The TAP Block- Exparel group used a mean of 0.22 Morphine milligram equivalents.
What this means
The trial results suggest that while both continuous epidural analgesia and TAP Block-Exparel provided comparable levels of post-operative pain control as measured by the Numeric Pain Scale, the TAP Block-Exparel group generally demonstrated a reduction in narcotic analgesia use. Notably, patients receiving TAP Block-Exparel used less morphine milligram equivalents on post-operative Day 0 (54.64 MME vs. 80.20 MME in one measurement) and significantly less on Day 1 (13.34 MME vs. 71 MME) and Day 3 (0.22 MME vs. 0.34 MME) compared to those with epidural analgesia. This reduction in opioid consumption could lead to fewer opioid-related side effects, potentially facilitating faster recovery and discharge for patients undergoing colorectal surgery. Clinicians may consider TAP Block-Exparel as an effective strategy to optimize post-operative pain management and reduce opioid burden.
Source
The information regarding these trial results was obtained from ClinicalTrials.gov, a public database of clinical studies. The results for study NCT02591407, titled "Trial Comparing Transversus Abdominis Plane Block Versus Epidural Anesthesia for Pain Management in Colorectal Surgery", were posted on 2026-01-28 on clinicaltrials.gov.