• Journal of anesthesia · Apr 2023

    Randomized Controlled Trial

    Modified thoracoabdominal nerve block through perichondrial approach (M-TAPA) vs local infiltration for pain management after laparoscopic cholecystectomy surgery: a randomized study.

    • Hande Güngör, Bahadir Ciftci, Selcuk Alver, Birzat Emre Gölboyu, Yasar Ozdenkaya, and Serkan Tulgar.
    • Department of Anesthesiology and Reanimation, Istanbul Medipol University, Bagcilar, 34040, Istanbul, Turkey.
    • J Anesth. 2023 Apr 1; 37 (2): 254260254-260.

    PurposeModified thoracoabdominal nerves block through perichondrial approach (M-TAPA) targets thoracoabdominal nerves. Our primary aim was to compare M-TAPA vs local infiltration on pain management in patients underwent laparoscopic cholecystectomy (LC) surgery.MethodsPatients with ASA class I-II patients aged between 18 and 65 years scheduled for elective LC under general anesthesia were enrolled in the study. There were two randomized groups: Group M: M-TAPA group (n = 30) and the local infiltration (LI) group (n = 30). M-TAPA was performed with totally 40 ml 0.25% bupivacaine in the M group. LI was performed in infiltration group. The primary outcome of the study was pain score in the PACU, the secondary outcomes were the patient satisfaction scores, rescue analgesic need, and adverse effects during the 24-h postoperative period.ResultsThe static NRS scores were significantly lower in Group M at the postoperative first 4 h (p = 0.001). There was a significant decrease in the dynamic NRS scores in Group M at the postoperative first 16 h (p = 0.001). The incidence of nausea was significantly higher in the LI group (12 vs. 5 patients, p = 0.047). The need for rescue analgesia was significantly lower in Group M (p = 0.009). The patient satisfaction scores were significantly higher in Group M (p = 0.001).ConclusionM-TAPA provides superior analgesia compared to LI in patients undergoing LC.© 2022. The Author(s) under exclusive licence to Japanese Society of Anesthesiologists.

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