This randomized controlled trial aims to compare the postoperative analgesic efficacy ofM-TAPA block and OSTAP block in patients undergoing laparoscopic inguinal hernia repair.Pain scores, analgesic consumption, and patient satisfaction will be evaluated.
Prospective, randomized, single-blind, controlled study including 90 patients undergoing
elective laparoscopic inguinal hernia repair. Patients will be randomized into three
groups: M-TAPA, OSTAP, and control. Postoperative pain scores (VAS), analgesic
consumption, time to first analgesic requirement, and patient satisfaction will be
assessed over 24 hours.
Procedure: Modified Thoracoabdominal Nerve Block Through Perichondrial Approach (M-TAPA)
Ultrasound-guided bilateral M-TAPA block performed with 20 mL of 0.25% bupivacaine per
side
Procedure: Oblique Subcostal Transversus Abdominis Plane Block (OSTAP)
Ultrasound-guided bilateral OSTAP block performed with 20 mL of 0.25% bupivacaine per
side
Other: Standard Analgesia use (paracetamol, contramal)
Patients received standard postoperative analgesia without regional block
Inclusion Criteria:
- Patients aged between 18 and 65 years
- American Society of Anesthesiologists (ASA) physical status I-II
- Scheduled for elective laparoscopic inguinal hernia repair (TEP technique)
- Ability to understand and use the Visual Analog Scale (VAS)
- Provided written informed consent
Exclusion Criteria:
- Refusal to participate or inability to provide informed consent
- Age under 18 or over 65 years
- ASA physical status ≥ III
- Coagulopathy (including abnormal INR, thrombocytopenia, or platelet dysfunction)
- Infection at the injection site
- Known allergy or hypersensitivity to study medications (local anesthetics, NSAIDs,
opioids)
- Chronic opioid use (longer than 4 weeks)
- Use of psychiatric medications affecting pain perception
- Inability to cooperate or communicate effectively
- Requirement for postoperative intensive care
Kartal Dr. Lütfi Kırdar City Hospital
Istanbul, Turkey (Türkiye)
Tahsin Simsek, MD, Principal Investigator
Kartal Dr. Lütfi Kirdar City Hospital