Modified thoracoabdominal nerve block with perichondrial approach in laparoscopic cholecystectomy surgery: a prospective, randomized, controlled, double-blind study

Authors : Muhammed Halit Satıcı, Nuray Altay, Betül Kozanhan, Munise Yıldız, Mahmut Sami Tutar, Ersin Turan

Pages : 569-578

Doi:10.18663/tjcl.1571553

View : 40 | Download : 89

Publication Date : 2024-12-31

Article Type : Research Paper

Abstract :Aim: Although laparoscopic cholecystectomy (LC) is considered minimally invasive, it can cause moderate to severe pain in the postoperative period. This study investigates the effects of modified thoracoabdominal nerve block with perichondrial approach (M-TAPA) on postoperative analgesia after LC. Material and Methods: The patients were divided into two groups: Group M (patients who received the M-TAPA block) and Group C (control group patients who did not receive the block). The primary outcome measures were the pain scores at 0, 2, 4, 8, 12, and 24 hours postoperatively. The secondary outcome measures included the total amount of rescue analgesic consumed, the time to first rescue analgesia, the occurrence of complications (nausea, and vomiting), and patient satisfaction. Results: When the change over time of the numerical rating scale (NRS) scores at 24 hours postoperative was evaluated for both rest and movement, the time*group interaction was statistically significant for NRS scores during both rest and movement (p<0.001 and p<0.001, respectively). The total amount of tramadol consumed within the first 24 hours after surgery was higher in Group C (220 (170-260) vs 70 (0-80); P<0.001). Rescue analgesia was administered to all patien ts in Group C; in Group M, 8 patients did not receive rescue analgesic (p<0.005). Conclusion: The use of M-TAPA as a component of a multimodal analgesia approach helps to reduce opioid consumption, thereby preventing opioid-related side effects and enhancing postoperative patient comfort.
Keywords : laparoskopik kolesistektomi, m-tapa, multimodal analjezi, numerik derecelendirme ölçeği