Laparoscopic cholecystectomy is a frequently performed surgical procedure and isconsidered the gold standard for treating symptomatic gallstone disease. Althoughlaparoscopic cholecystectomy is considered minimally invasive, it can cause moderate tosevere pain in the postoperative period. Poorly controlled early postoperative pain canimpair recovery quality and increase the risk of postoperative pulmonary complications asa risk factor for chronic pain development. Multimodal analgesia, including opioids, isused to limit pain following laparoscopic cholecystectomy. However, opioid treatment maylead to side effects such as postoperative nausea and vomiting (PONV), respiratorydepression, and constipation.Nerve blocks provide better pain control, reduce opioid consumption in the postoperativeperiod, and offer advantages such as fewer side effects and a lower risk of pulmonary andcardiac complications.In our clinic, a multimodal analgesia approach is preferred for patients undergoinglaparoscopic cholecystectomy. In addition to intravenous analgesic agents, peripheralnerve blocks are administered based on patient preference (for all eligible andconsenting patients).This study aims to compare the postoperative analgesic efficacy of the TransversusAbdominis Plane (TAP) Block and the Modified Thoracoabdominal Nerve Block with aPericostal Approach (M-TAPA) in patients undergoing laparoscopic cholecystectomy.Standard analgesic methods are applied to patients who do not consent to peripheral nerveblock administration.
Not Provided
Drug: Transversus Abdominis Plane (TAP) Block
Transversus Abdominis Plane (TAP) Block is performed under ultrasound guidance before the
surgical procedure and anesthesia induction, with the patient in the supine position.
Drug: Modified Thoracoabdominal Nerve Block (M-TAPA)
Modified Thoracoabdominal Nerve Block (M-TAPA) is performed under ultrasound guidance
before the surgical procedure and anesthesia induction, with the patient in the supine
position.
Inclusion Criteria:
- 18 to 65 years old
- American Society of Anesthesiologists (ASA) physical status I-II-III
- Body mass index 18 to 30 kg/m2
- Elective laparoscopic cholecystectomy surgery
Exclusion Criteria:
- Under 18 and over 65
- ASA score IV and above
- Advanced co-morbidity
- History of bleeding diathesis
- Patient refusing the procedure
- Chronic opioid or analgesic use
- Patients who will operate under emergency conditions
- Block injection site infection
- Known allergy to local anesthetics
- Pregnancy
Ankara Etlik City Hospital
Yenimahalle, Ankara, Turkey
MÜRÜVVET TAŞKIR TURAN, MD
00905065536934
taskirmuruvvet@gmail.com
MUSA ZENGİN, Associate Professor
00905307716235
musazengin@gmail.com
Not Provided