Postoperative pain after laparoscopic cholecystectomy can negatively affect patientcomfort, recovery, and opioid consumption. Regional abdominal wall blocks are commonlyused as part of multimodal analgesia to improve postoperative pain control and reduceopioid-related side effects.The modified thoracoabdominal nerve block through the perichondrial approach (M-TAPA) andthe erector spinae plane block (ESPB) are two ultrasound-guided regional anesthesiatechniques that have been shown to provide effective postoperative analgesia in abdominalsurgery. However, comparative clinical data between these two techniques in laparoscopiccholecystectomy are limited.This randomized, single-blind clinical trial aims to compare the postoperative analgesiceffectiveness of M-TAPA and ESPB in adult patients undergoing elective laparoscopiccholecystectomy. Postoperative pain scores, opioid consumption, time to first analgesicrequirement, and patient satisfaction will be evaluated.
This study is designed as a prospective, randomized, single-blind controlled clinical
trial conducted in adult patients scheduled for elective laparoscopic cholecystectomy.
The primary objective of the study is to compare the postoperative analgesic
effectiveness of the modified thoracoabdominal nerve block through the perichondrial
approach (M-TAPA) and the erector spinae plane block (ESPB).
Eligible patients aged 18 to 65 years with American Society of Anesthesiologists (ASA)
physical status I-II will be randomly assigned in a 1:1 ratio to receive either M-TAPA or
ESPB. Randomization will be performed using a computer-generated random number sequence,
and allocation will be concealed in sealed, opaque envelopes to prevent selection bias.
All blocks will be performed under ultrasound guidance by experienced anesthesiologists
using standard local anesthetic agents routinely applied in clinical practice. The study
is designed as single-blind, with patients blinded to group allocation.
Postoperative pain intensity will be assessed using the visual analog scale (VAS) at 0,
1, 6, 12, and 24 hours after surgery. Additional outcome measures include total opioid
consumption within the first 24 postoperative hours, time to first analgesic requirement,
need for rescue analgesia, and patient satisfaction. Adverse events related to regional
anesthesia techniques will be recorded.
The study follows the principles of the Declaration of Helsinki and Good Clinical
Practice guidelines. Ethical approval has been obtained from the relevant Clinical
Research Ethics Committee prior to study initiation.
Procedure: Modifiye throcoabdominal nerve block through the perichondrial approach (M-TAPA)
An ultrasound-guided modified thoracoabdominal nerve block through the perichondrial
approach (M-TAPA) performed bilaterally using local anesthetic for postoperative
analgesia after laparoscopic cholecystectomy.
Procedure: erector spinae plane block (ESPB)
An ultrasound-guided erector spinae plane block (ESPB) performed using local anesthetic
for postoperative analgesia after laparoscopic cholecystectomy.
Inclusion Criteria:
- Adult patients aged 18-65 years
- ASA physical status I-III
- Scheduled for elective surgery under general anesthesia
- Ability to understand the study procedures and provide written informed consent
Exclusion Criteria:
- Refusal to participate
- Known allergy to local anesthetics
- Coagulation disorders or anticoagulant therapy
- Infection at the injection site
- Severe hepatic, renal, or cardiac disease
- Chronic opioid use
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Muzaffer Gencer
+90 505 9436459
dr.m.gencer07@gmail.com
Not Provided