Study Comparing Two Methods of TransversusAbdominis Plane (CHIRTAP)

Randomised Study of Noninferiority Comparing a TransversusAbdominis Plane Block Surgical (c-TAP Block) to the Ultrasound-guided Abdominis Plane Block Transversus (Us-TAP Block) in Postoperative Analgesia After Laparoscopy or Laparotomy

Interventional, randomised, prospective, multicentric and single blind study Primary objective : demonstrate the equivalence of c-TAP Block to us-TAP Block in postoperative analgesia Secondary objective : Assess the effectiveness of c-TAP block on us-TAP Block in the obese and/or malnourished patient subgroup Compare the running time of the c-TAP Block to the us-TAP Block Assess the safety of the c-TAP Block gesture in terms of trauma to the intraperitoneal organs by the injection needle two groups: Arm A : c-TAP Block performed by the surgeon Arm B : us-TAP Block performed by the anesthesist under ultrasound control Schedule : Inclusions start at: 16/09/2019 End date of inclusions: 31/03/2022 End date of follow-up: 01/04/2022 Study report: 30/09/2022

The US-TAP is performed by the anesthetist under ultrasound control after the end of the procedure of laparoscopy or laparotomy. Under sterile conditions, the anesthetist identifies the oblique abdominal muscles externally, obliquely internally and transversely by ultrasound. A 20 ml needle of 0.5% ropivacaine is injected. The surgical TAP (c-TAP) block is performed by the surgeon at the end of the procedure of laparoscopy or laparotomy.The needle and the product used are identical to those of the us-TAP block. The positioning of the needle is in the plane of the fascia between the internal oblique muscle and the transverse muscle, identified by a significant loss of resistance.

Evolution pain intensity scores, assessed by the numerical pain scale (EN), postoperative and need for systemic analgesics (intravenously or by mouth) during the 24 hours following the end of the procedure

The failure will be defined as follows: a pain evaluated at> 4/10 on EN that requires intravenous or systemic analgesia

The time will be quantified with a stopwatch. For the c-TAP, the stopwatch will be started as soon as the injection equipment of the locoregional anesthesia is received. For the us-TAP block, the stopwatch will be started after the end of the surgical procedure and as soon as the anesthetist starts to wash his hands to proceed with the injection

Inclusion Criteria: Patient over 18 years old Patient undergoing laparoscopic or laparotomic abdominal surgery at the investigator hospital. Patient mastering the French language Patient who received informed information about the study and signed a consent Patient affiliated to a social security scheme. Exclusion Criteria: Patients with chronic pain Patients with opioid dependence Patients allergic to local anesthetic Patient who has not signed the consent of the study.