Comparison of M-TAPA Block and Intraperitoneal Analgesia in Postoperative Pain Management After Laparoscopic Cholecystectomy: A Randomized Controlled Trial

Authors : Fatih Balcı, Levent Zirek, Muhammed Nail Tekcan
Pages : 352-359
Doi:10.46332/aemj.1686610
View : 37 | Download : 79
Publication Date : 2025-12-22
Article Type : Research Paper
Abstract :Purpose: Laparoscopic cholecystectomy (LC) is a minimally invasive surgical procedure offering reduced postoperative pain, shorter hospital stays, and faster recovery. Despite these benefits, pain from tissue trauma, pneumoperitoneum, and gallbladder removal remains significant. This study compares the analgesic efficacy of the Modified Thoracoabdominal Nerve Block via Perichondrial Approach (M-TAPA) and intraperitoneal bupivacaine with or without dexmedetomidine in patients undergoing LC. Materials and Methods: This prospective, randomized, single-blind trial included 60 ASA I/II patients undergoing elective LC under general anesthesia. Patients were divided into three groups: M-TAPA block (Group M), intraperitoneal bupivacaine (Group B), and intraperitoneal bupivacaine plus dexmedetomidine (Group BD). Postoperative pain was assessed using the Numeric Rating Scale (NRS) at six-hour intervals for 24 hours. Secondary outcomes included rescue analgesic requirements and side effects. Data were analyzed using ANOVA, Kruskal-Wallis, and Bonferroni post hoc tests. Results: Group BD and Group M showed significantly lower NRS scores compared to Group B (p<0.05), with no statistical difference between Group BD and Group M. None of the patients required rescue analgesics. Bradycardia and hypotension were observed in two patients in Group BD but resolved with atropine. Group M achieved effective analgesia without side effects. Conclusion: M-TAPA block and intraperitoneal bupivacaine with dexmedetomidine provide comparable analgesia after LC. The MTAPA block is a safe and effective alternative with fewer side effects, making it a favorable option for postoperative pain management in LC patients.
Keywords : akut ağrı, rejyonel anestezi, sinir bloğu, ultrasonografi

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