ClinicalTrials.gg
CompletedNCT03367728LapTAPUpdated Aug 31, 2026

The Use of Laparoscopic Transversus Abdominis Plane Block in Gastric Bypass Surgery (LapTAP)

A Phase 4 interventional study of Ropivacaine and Normal saline in Bariatric Surgery Candidate, sponsored by Ottawa Hospital Research Institute. Completed at 1 site in Canada. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-08-31.

Sponsored by Ottawa Hospital Research Institute · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
148
Allocation
Randomized
Ages
18 Years and older
Sex
All
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Study summary

Randomized, Double-Blinded, Placebo-Controlled Trial of Laparoscopic Transverse Abdominis Plane (Lap TAP) and Rectus Sheath Block in elective Gastric Bypass Surgery aiming to evaluate the benefit of a laparoscopically -guided, surgical transversus abdominis plane (TAP) block and rectus sheath block in reducing post-operative opioid consumption and improving outcomes in patients undergoing laparoscopic gastric bypass surgery. The results of this study will provide further evidence on the optimal means to obtain analgesia in patients undergoing gastric bypass surgery

Read the detailed description

Management of post-operative pain remains a major challenge and an area of continued research. Effective pain control, apart from providing general patient comfort, is critical for a variety of clinical reasons. It leads to early ambulation and improved respiratory function, which significantly reduces the risk of post-operative complications such as pulmonary embolus or pneumonia, as well as early discharge.

Post-operative pain management was typically opioid-based; however, post-operative opioid use may be associated with increased risk of respiratory depression and sedation. It is therefore desirable to implement opioid sparing multimodal analgesia to achieve satisfactory pain control while reducing post-operative opioid requirements and their side-effects.

Rational pain management is a particularly pertinent issue in the patients with morbid obesity (MO). The pathophysiology of obesity, the high prevalence of obstructive sleep apnea, and high susceptibility to respiratory depression amongst patients with MO make safe analgesic (pain) management especially difficult. These individuals are at high risk of post-operative adverse respiratory events, nosocomial infections, cardiovascular complications, and pulmonary emboli (the second leading cause of death in the bariatric surgery population).

Given the increasing number of patients with MO presenting for elective weight loss surgery, it is important to understand and optimize the analgesic requirements of this patient population. However, there are limited evidence-based recommendations and no ideal analgesic regimen exists for patients with MO. Current recommendations include use of step-wise severity-based opioid- sparing multimodal analgesia. It is possible that including local anesthetic blocks will further reduce pain, opioid analgesic consumption and side-effects from pain management (sedation, confusion, nausea \& vomiting etc.) at-risk patient population.

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Conditions studied

  • Bariatric Surgery Candidate

Keywords

  • Bariatric Surgery
  • Bariatrics
  • Ropivacaine
  • Randomized Controlled Trial
  • Enhanced Recovery After Bariatric Surgery
  • TAP Block
  • Rectus Sheath Block
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In context

Lead sponsor

Ottawa Hospital Research Institute is the lead sponsor of 547 studies on the registry; 99 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Patients undergoing Roux-en-Y gastric bypass surgery;
  • Patients who able to tolerate general anesthetic and pneumoperitoneum;
  • Patients who able to provide for the surgery;
  • Patients over the age of 18 years;

Exclusion criteria

Exclusion Criteria:

  • Patient undergoing planned sleeve gastrectomy (intra-op conversion to sleeve gastrectomy after delivery of Ropivacaine/placebo will be included and analyzed using intention-to-treat approach)
  • Patients with an allergy to local anesthetics
  • Patients with severe underlying cardiovascular disease (ie: congestive heart failure, conduction abnormalities, and ischemic heart disease)
  • Patients with chronic renal disease Stage 3 or greater ( less than 60mL/min)
  • Patients with hepatic dysfunction Class B or C
  • Patients with previous foregut surgery including esophageal, gastric, liver, and pancreas resections
  • Patients weighing less than or equal to 100 kilograms as measured in the pre-admission unit
  • Patients enrolled in any other study involving involve tissue .
  • Patients with Chronic Pain and Chronic Opioid use- Oral Morphine Equivalent of >100mg/day
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

Child-Pugh class

A score of how well the liver works in people with liver disease such as cirrhosis: class A is mild, B moderate and C severe.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

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Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
148 participants (actual)

Study arms

  • Placebo comparator
    TAP and Rectus Sheath Normal Saline

    TAP and Rectus Sheath Block of 60 mL Normal Saline divided into 4 injections administered as in Experimental Arm.

    Drug: Normal saline

  • Experimental
    TAP and Rectus Sheath ropivacaine

    The block will be administered in the anterior abdominal wall. For the TAP block, the standard technique will be followed- at the anterior axillary line midway between the subcostal margin and iliac crest. For the rectus sheath block, a bilateral sub-xiphoid approach will be used. There will be 4 injection sites in total and the size of the needle will be standardized to an 18g spinal needle 10cms. Using laparoscopic visualization, the transversus abdominis muscles were identified lateral to the semilunar line. Ropivacaine to be infiltrated will be divided into 4 equal amounts. The procedure is then repeated 2 times in the transversus abdominis plane (20mL each) and 2 times as a Rectus Sheath Block (10mL each) with a total amount of 60 mL.

    Drug: Ropivacaine

Interventions

  • TAP and Rectus Sheath Block Injections of Ropivacaine

    Also known as: NAROPIN®, 84057-95-4

  • DrugNormal saline

    TAP and Rectus Sheath Block Injections of Normal Saline

    Also known as: Sodium Chloride, 7647-14-5

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What researchers measure

Primary outcomes

  1. Cumulative postoperative narcotic use

    Cumulative postoperative narcotic use administered within 24 hours post-operatively

    Time frame: Hour 0-24 post operatively, baseline and Follow-up use of narcotics will be recorded for population description

Secondary outcomes

  1. Peak Expiratory flow score

    measured by the spirometry 60 - 850 liters per minute. Peak expiratory force has not been studied extensively in obese patients. Currently, there is no recommendation on what constitutes a clinically significant change. Recovery to baseline will be sought.

    Time frame: Surgery consent visit, morning of surgery, Hour 0-24 post operatively, Follow-up (7-10 days post op)

  2. Pain score

    measured by the 0-10 Numeric pain rating score

    Time frame: Surgery consent visit, morning of surgery, Hour 0-24 post operatively, Follow-up (7-10 days post op)

  3. 6-minute walk distance (6MWD)

    the distance (m) an individual is able to walk along a flat 30 m walkway over a six-minute period, with breaks as required

    Time frame: Surgery consent visit, morning of surgery, Hour 0-24 post operatively, Follow-up (7-10 days post op)

  4. Quality of Life Questionnaire (QOR-40) (Explanatory Outcome)

    Assessment of different aspects of quality of life using validated questionnaire

    Time frame: Surgery consent visit, morning of surgery, Hour 0-24 post operatively, Follow-up (7-10 days post op)

07

Study locations

1 site
  • The Ottawa Hospital
    Ottawa, Ontario K1Y 4E9, Canada
08

References and documents

Publications

  • Jarrar A, Budiansky A, Eipe N, Walsh C, Kolozsvari N, Neville A, Mamazza J. Randomised, double-blinded, placebo-controlled trial to investigate the role of laparoscopic transversus abdominis plane block in gastric bypass surgery: a study protocol. BMJ Open. 2020 Jun 28;10(6):e025818. doi: 10.1136/bmjopen-2018-025818. PubMed 32595142 ↗

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: Yes — Available upon request and all data requests have to be approved by our institution research ethics board

Supporting information: Study protocol, Statistical analysis plan, Informed consent form

Time frame: Within 6 months of completion

Access criteria: Requests are reviewed by the institutional research ethics board.

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Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Nov 2018 to primary completion in Feb 2020, 15 months.

How these figures are worked out, and which studies are left out of them.

Registered
Dec 5, 2017
First posted
Dec 11, 2017
StartActual
Nov 27, 2018
Primary completionActual
Feb 28, 2020
CompletionActual
Mar 6, 2020
Last update
Aug 31, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Aug 31, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT03367728
Responsible party
Sponsor
First posted
Dec 11, 2017
Start date
Nov 27, 2018
Primary completion
Feb 28, 2020
Completion
Mar 6, 2020
Last update
Aug 31, 2026

Study contacts

Joseph Mamazza, MD
principal investigator · The Ottawa Hospital

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Aug 2026. You cannot join it, but the record below documents what was studied.

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Studies of the drug tested here: Ropivacaine

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