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Original Research

Open Access

Postoperative analgesic efficacy of the thoracoabdominal nerves block through perichondrial approach (TAPA) and modified-TAPA for laparoscopic cholecystectomy: a randomized controlled study

  • Tuna ERTÜRK1
  • Ayşın ERSOY1

1Department of Anesthesiology, University of Health Sciences, Sultan 2. Abdulhamid Han Training and Research Hospital, 34668 Istanbul, Turkey

DOI: 10.22514/sv.2022.004

Submitted: 02 October 2021 Accepted: 25 November 2021

Online publish date: 05 January 2022

*Corresponding Author(s): Tuna ERTÜRK E-mail: tunaerturk22@yahoo.com

Abstract

Laparoscopic cholecystectomy is one of the most common surgical procedures. Even though there is less postoperative pain with laparoscopic cholecystectomy than with open cholecystectomy, severe pain can occur, particularly within the first 24 hours. Evaluation of the efficacy of ultrasound-guided interfascial plane blocks for postoperative analgesia of laparoscopic cholecystectomy has recently come to prominence. The aim of our study was to compare the postoperative analgesic efficacy of thoracoabdominal nerves block through perichondrial approach (TAPA) and modified-TAPA (m-TAPA) blocks in patients who underwent laparoscopic cholecystectomy. The present study included 56 patients who underwent laparoscopic cholecystectomy under general anesthesia and received TAPA or m-TAPA block for perioperative analgesia. Each patient signed a written informed consent form. Block times and numerical rating scale (NRS) scores 1, 2, 3, and 12 hours postoperatively, hourly and total tramadol amount of use via the patient-controlled analgesia device, and additional analgesic drug consumption were all recorded. The TAPA group had significantly longer block application times than the m-TAPA group. At 1 and 12 hours, NRS scores were lower in the TAPA group. However, the mean NRS scores, total tramadol use, and use of additional analgesics were comparable between the groups. TAPA and m-TAPA block methods reduced NRS scores by alleviating pain after laparoscopic cholecystectomy procedures, thereby reducing the need for additional analgesics. Block times for TAPA were significantly longer than those for m-TAPA. However, both block applications were completed in a short period, smoothly and safely. The analgesic effect of TAPA block was more distinctive at 1 and 12 hours, and NRS scores were lower. However, we think that both block methods, when used under ultrasound guidance, will provide effective analgesia by supplementing the multimodal analgesia planned for laparoscopic cholecystectomy and other abdominal operations.


Keywords

Laparoscopic cholecystectomy; TAPA block; m-TAPA block; Postoperative pain


Cite and Share

Tuna ERTÜRK,Ayşın ERSOY. Postoperative analgesic efficacy of the thoracoabdominal nerves block through perichondrial approach (TAPA) and modified-TAPA for laparoscopic cholecystectomy: a randomized controlled study. Signa Vitae. 2022.doi:10.22514/sv.2022.004.

References

[1] Molfino S, Botteri E, Baggi P, Totaro L, Huscher M, Baiocchi GL, et al. Pain control in laparoscopic surgery: a case–control study between transversus abdominis plane-block and trocar-site anesthesia. Updates in Surgery. 2019; 71: 717–722.

[2] Tekeli AE, Eker E, Bartin MK, Öner M. The efficacy of transversus abdominis plane block for postoperative analgesia in laparoscopic cholecystectomy cases: a retrospective evaluation of 515 patients. Journal of International Medical Research. 2020; 48: 030006052094405.

[3] Mitra S, Khandelwal P, Roberts K, Kumar S, Vadivelu N. Pain relief in laparoscopic cholecystectomy—a review of the current options. Pain Practice. 2012; 12: 485–496.

[4] Karasu D. Ultrasound-Guided Transversus Abdominis Plane Block for Postoperative Analgesia in Laparoscopic Cholecystectomy: a Retrospective Study. Northern Clinics of Istanbul. 2020; 8: 88–94.

[5] Fernández Martín MT, López Álvarez S, Pérez Herrero MA. Serratus-intercostal interfascial block as an opioid-saving strategy in supra-umbilical open surgery. Revista Espanola de Anestesiologia y Reanima-cion. 2018; 65: 456–460.

[6] Tulgar S, Senturk O, Selvi O, Balaban O, Ahiskalioğlu A, Thomas DT, et al. Perichondral approach for blockage of thoracoabdominal nerves: Anatomical basis and clinical experience in three cases. Journal of Clinical Anesthesia. 2019; 54: 8–10.

[7] Tulgar S, Selvi O, Thomas DT, Deveci U, Özer Z. Modified thora-coabdominal nerves block through perichondrial approach (M-TAPA) provides effective analgesia in abdominal surgery and is a choice for opioid sparing anesthesia. Journal of Clinical Anesthesia. 2019; 55: 109.

[8] Khan KK, Khan RI. Analgesic Effect of Bilateral Subcostal Tap Block after Laparoscopic Cholecystectomy. Journal of Ayub Medical College. 2018; 30: 12–15.

[9] Suseela I, Anandan K, Aravind A, Kaniyil S. Comparison of ultrasound-guided bilateral subcostal transversus abdominis plane block and port-site infiltration with bupivacaine in laparoscopic cholecystectomy. Indian Journal of Anaesthesia. 2018; 62: 497–501.

[10] Szental JA, Webb A, Weeraratne C, Campbell A, Sivakumar H, Leong S. Postoperative pain after laparoscopic cholecystectomy is not reduced by intraoperative analgesia guided by analgesia nociception index (ANI®) monitoring: a randomized clinical trial. British Journal of Anaesthesia. 2015; 114: 640–645.

[11] Aygun H, Kavrut Ozturk N, Pamukcu AS, Inal A, Kiziloglu I, Thomas DT, et al. Comparison of ultrasound guided Erector Spinae Plane Block and quadratus lumborum block for postoperative analgesia in laparoscopic cholecystectomy patients: a prospective randomized study. Journal of Clinical Anesthesia. 2020; 62: 109696.

[12] Ökmen K, Metin Ökmen B, Topal S. Ultrasound-guided posterior quadratus lumborum block for postoperative pain after laparoscopic cholecystectomy: a randomized controlled double blind study. Journal of Clinical Anesthesia. 2018; 49: 112–117.

[13] Chen Y, Shi K, Xia Y, Zhang X, Papadimos TJ, Xu X, et al. Sensory Assessment and Regression Rate of Bilateral Oblique Subcostal Transversus Abdominis Plane Block in Volunteers. Regional Anesthesia and Pain Medicine. 2018; 43: 174–179.

[14] Hajong R, Khariong PDS, Baruah AJ, Anand M, Khongwar D. Laparoscopic cholecystectomy under epidural anesthesia: a feasibility study. North American Journal of Medical Sciences. 2014; 6: 566–569.

[15] Mehta N, Dar MR, Sharma S, Mehta KS. Thoracic combined spinal epidural anesthesia for laparoscopic cholecystectomy: a feasibility study. Journal of Anaesthesiology Clinical Pharmacology. 2016; 32: 224–228.

[16] Daghmouri MA, Akremi S, Chaouch MA, Mesbahi M, Amouri N, Jaoua H, et al. Bilateral Erector Spinae Plane Block for Postoperative Analgesia in Laparoscopic Cholecystectomy: a Systematic Review and Meta-analysis of Randomized Controlled Trials. Pain Practice. 2021; 21: 357–365.

[17] Herman JA, Urits I, Kaye AD, Urman RD, Viswanath O. Erector Spinae Plane Block (ESPB) or Quadratus Lumborum Block (QLB-II) for laparoscopic cholecystectomy: Impact on postoperative analgesia. Journal of Clinical Anesthesia. 2020; 66: 109958.

[18] Güven BB, Ertürk T, Güner T, Ersoy A. Abdominal wall blocks for emergency ileostomy operation in a patient with COVID-19 pneumonia: a case report. Brazilian Journal of Anesthesiology. 2021; 71: 572–575.



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