Tranversus Abdominis Plane (TAP) Block vs. Systemic Lidocaine: Effects on Recovery After Outpatient Gynecological Laparoscopy

It has been demonstrated that female patients have poor quality of surgical recovery
compared to male patients. Increased sensitivity to pain and increased susceptibility to
postoperative nausea and vomiting have been attributed as causal factors. Currently, few
strategies have been shown to improve quality of recovery in female patients undergoing
laparoscopic hysterectomy. A better recovery in female patients undergoing outpatient
laparoscopy is particularly desirable since those patients do not have access to potent
intravenous medications and nursing support after hospital discharge.

Our group has previously demonstrated that both TAP block and systemic lidocaine improve
quality of recovery after outpatient laparoscopic gynecological surgery. The TAP block,
however, requires expertise, equipment (ultrasound), and additional time to perform as
compared with a simple lidocaine infusion. It is currently unknown if a systemic lidocaine
infusion provides non-inferior quality of recovery when compared to TAP block for outpatient
laparoscopic gynecological surgery.

The main objective of the current investigation is to examine the effect of TAP block on
quality of recovery compared to a systemic lidocaine infusion. We hypothesize that systemic
lidocaine infusion would provide non-inferior quality of recovery when compared to TAP block
for outpatient laparoscopic gynecological surgery.

Significance: This is the first study to compare systemic lidocaine to TAP block with regard
to quality of recovery.

The research question; does systemic lidocaine provide similar quality of recovery as TAP
block for outpatient laparoscopy? The hypothesis; systemic lidocaine provides non-inferior
quality of recovery as TAP block for outpatient laparoscopy.

Research significance: It has been shown that females have poor surgical recovery compared
to males; this project intends to demonstrate that systemic lidocaine provides similar
recovery as TAP blocks but it does not require the expertise, equipment, and time needed to
perform TAP blocks.