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Suzuka T, Tanaka N, Kadoya Y, Yamanaka T, Ida M, Nakade H, Kunishige T, Matsumoto S, Ozu N, Kawaguchi M. Comparison of Analgesic Method in Laparoscopic Gastrectomy Using External Oblique Intercostal Block Versus Wound Infiltration: A Randomized Controlled Trial. J Clin Med 2024; 13:4174. [PMID: 39064215 PMCID: PMC11278287 DOI: 10.3390/jcm13144174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 07/11/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
Background: External oblique intercostal block (EOIB) is effective in relieving pain in the T6 to T10 dermatomes; however, there is limited evidence comparing EOIB with conventional regional anesthesia. In this randomized controlled trial, it was hypothesized that EOIB would provide more effective analgesia than wound infiltration (WI) in laparoscopic gastrectomy. Methods: Thirty-two patients (aged 20-85 years) with American Society of Anesthesiologists Performance Status of 1 to 2, scheduled for laparoscopic gastrectomy, were randomly divided into EOIB and WI groups. Both procedures were performed using 40 mL of 0.25% levobupivacaine. The primary outcome was the numerical rating scale (NRS) score 12 h postoperatively. Secondary outcomes were NRS at 2, 24, and 48 h postoperatively, variation in quality of recovery-15 score on postoperative days 1 and 2 from preoperative baseline, postoperative fentanyl consumption, and variation in World Health Organization Disability Assessment Scale 2.0 scores between baseline and 3 months postoperatively. Plasma concentrations of levobupivacaine and pinprick sensation in the T4-11 dermatomes post-EOIB were evaluated to determine the exploratory endpoints. Results: There were no differences in the NRS scores 12 h postoperatively at rest and during movement between the EOIB and WI groups (mean standard deviation 1.3 [1.1] vs. 1.5 [1.4] and 3.1 [1.6] vs. 3.8 [1.7], respectively). Secondary outcomes did not differ significantly between the groups. The time to peak plasma concentration of levobupivacaine following EOIB was 45 min. Conclusions: No significant differences in NRS scores were observed between the analgesic effects of EOIB and WI at 12 h postoperatively.
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Affiliation(s)
- Takanori Suzuka
- Department of Anesthesiology, Nara Medical University, Kashihara 634-8522, Japan; (T.S.); (M.I.); (M.K.)
| | - Nobuhiro Tanaka
- Department of Anesthesiology, Nara Medical University, Kashihara 634-8522, Japan; (T.S.); (M.I.); (M.K.)
| | - Yuma Kadoya
- Department of Anesthesiology, Ikeda City Hospital, Ikeda 563-8510, Japan;
| | - Takayuki Yamanaka
- Department of Anesthesiology, Nara Prefecture General Medical Center, Nara 630-8054, Japan;
| | - Mitsuru Ida
- Department of Anesthesiology, Nara Medical University, Kashihara 634-8522, Japan; (T.S.); (M.I.); (M.K.)
| | - Hiroshi Nakade
- Department of Surgery, Nara Medical University, Kashihara 634-8522, Japan; (H.N.); (T.K.); (S.M.)
| | - Tomohiro Kunishige
- Department of Surgery, Nara Medical University, Kashihara 634-8522, Japan; (H.N.); (T.K.); (S.M.)
| | - Sohei Matsumoto
- Department of Surgery, Nara Medical University, Kashihara 634-8522, Japan; (H.N.); (T.K.); (S.M.)
| | - Naoki Ozu
- Institute for Clinical and Translational Science, Nara Medical University Hospital, Kashihara 634-8522, Japan;
| | - Masahiko Kawaguchi
- Department of Anesthesiology, Nara Medical University, Kashihara 634-8522, Japan; (T.S.); (M.I.); (M.K.)
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Ohgoshi Y, Anetai H, Hanai S, Ichimura K, Kawagoe I. The key to success in blocking lateral cutaneous branches with re-modified thoracoabdominal nerves block through perichondrial approach: a newly discovered space between the endothoracic fascia, diaphragm, and costodiaphragmatic recess. J Anesth 2024:10.1007/s00540-024-03366-w. [PMID: 38940927 DOI: 10.1007/s00540-024-03366-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Accepted: 06/15/2024] [Indexed: 06/29/2024]
Abstract
PURPOSE This study aimed to determine whether the administration of a modified thoracoabdominal nerves block through perichondrial approach (M-TAPA) could result in the blockade of the lateral cutaneous branches. This study focused on a newly discovered anatomical space/plane adjacent to the M-TAPA plane, which we termed "space between the endothoracic fascia, diaphragm, and costodiaphragmatic recess: SEDIC." METHODS Thirteen sides of nine formalin-embalmed cadavers were macroscopically dissected to investigate the anatomical spaces related to the effects of M-TAPA. Furthermore, ten adult volunteers were administered 20 mL of 0.2% ropivacaine into the abdominal plane (corresponding to the M-TAPA plane) and the SEDIC, and a pinprick test was performed 1 h after the injection. RESULTS Cadaver macrodissection revealed the presence of the SEDIC adjacent to the M-TAPA plane. The SEDIC was completely spatially isolated from the M-TAPA plane by the presence of costal cartilage and/or tendinous structures. In the volunteer study, the administration of local anesthetics into the SEDIC effectively blocked the lateral cutaneous branches of T8-T12, in addition to the anterior branches. CONCLUSION Our study revealed the presence of the SEDIC adjacent to the M-TAPA plane. Administration of local anesthetics into the SEDIC, named re-modified TAPA, may have the potential to enhance the analgesic effect in the abdominal region.
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Affiliation(s)
- Yuichi Ohgoshi
- Department of Anesthesiology, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama, Kanagawa, Japan.
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan.
| | - Hidaka Anetai
- Department of Nursing, School of Health Sciences, Tokyo University of Technology, Tokyo, Japan
- Department of Anatomy and Life Structure, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Sayako Hanai
- Department of Anesthesiology, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama, Kanagawa, Japan
| | - Koichiro Ichimura
- Department of Anatomy and Life Structure, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Izumi Kawagoe
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan
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Ohgoshi Y, Kawagoe I. In reply: Comments on blockade of thoracoabdominal nerves through the perichondrial approach. Can J Anaesth 2024; 71:923-924. [PMID: 37907814 DOI: 10.1007/s12630-023-02632-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 11/02/2023] Open
Affiliation(s)
- Yuichi Ohgoshi
- Department of Anaesthesiology, Keiyu Hospital, Kanagawa, Japan.
- Department of Anaesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan.
| | - Izumi Kawagoe
- Department of Anaesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan
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Tulgar S. Comments on blockade of thoracoabdominal nerves through the perichondrial approach. Can J Anaesth 2024; 71:921-922. [PMID: 37907813 DOI: 10.1007/s12630-023-02631-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 09/11/2023] [Accepted: 09/11/2023] [Indexed: 11/02/2023] Open
Affiliation(s)
- Serkan Tulgar
- Department of Anesthesiology and Reanimation, Samsun Training and Research Hospital, Samsun University, Samsun, Turkey.
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Hirai N, Tanaka N, Suzuka T, Kadoya Y, Kawaguchi M. Letter to the editor regarding 'Modified thoracoabdominal nerve block through perichondrial approach (M-TAPA): an anatomical study evaluating dye spread following simulated injection in soft embalmed Thiel cadaver'. Reg Anesth Pain Med 2024; 49:376-377. [PMID: 37258033 DOI: 10.1136/rapm-2023-104686] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 05/23/2023] [Indexed: 06/02/2023]
Affiliation(s)
- Natsuko Hirai
- Department of Anesthesiology, Nara Medical University, Kashihara, Nara, Japan
| | - Nobuhiro Tanaka
- Department of Anesthesiology, Nara Medical University, Kashihara, Nara, Japan
| | - Takanori Suzuka
- Department of Anesthesiology, Nara Medical University, Kashihara, Nara, Japan
| | - Yuma Kadoya
- Department of Anesthesiology, Nara Medical University, Kashihara, Nara, Japan
| | - Masahiko Kawaguchi
- Department of Anesthesiology, Nara Medical University, Kashihara, Nara, Japan
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Suzuka T, Tanaka N, Kadoya Y, Ida M, Iwata M, Ozu N, Kawaguchi M. Comparison of Quality of Recovery between Modified Thoracoabdominal Nerves Block through Perichondrial Approach versus Oblique Subcostal Transversus Abdominis Plane Block in Patients Undergoing Total Laparoscopic Hysterectomy: A Pilot Randomized Controlled Trial. J Clin Med 2024; 13:712. [PMID: 38337406 PMCID: PMC10856699 DOI: 10.3390/jcm13030712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
Modified thoracoabdominal nerves block through a perichondrial approach (M-TAPA) provides a wide analgesic range. Herein, we examined the quality of recovery (QoR) of M-TAPA for total laparoscopic hysterectomy (TLH) compared with oblique subcostal transversus abdominis plane block (OSTAPB) and measured plasma levobupivacaine concentrations (PClevo). Forty female patients undergoing TLH were randomized to each group. Nerve blocks were performed bilaterally with 25 mL of 0.25% levobupivacaine administered per side. The primary outcome was changes in QoR-15 scores on postoperative days (POD) 1 and 2 from the preoperative baseline. The main secondary outcomes were PClevo at 15, 30, 45, 60, and 120 min after performing nerve block. Group differences (M-TAPA-OSTAPB) in mean changes from baseline in QoR-15 scores on POD 1 and 2 were -11.3 (95% confidence interval (CI), -24.9 to 2.4, p = 0.104; standard deviation (SD), 22.8) and -7.0 (95% CI, -20.5 to 6.6, p = 0.307; SD, 18.7), respectively. Changes in PClevo were similar in both groups. The post hoc analysis using Bayesian statistics revealed that posterior probabilities of M-TAPA being clinically more effective than OSTAPB were up to 22.4 and 24.4% for POD 1 and 2, respectively. In conclusion, M-TAPA may not be superior to OSTAPB for TLH.
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Affiliation(s)
- Takanori Suzuka
- Department of Anesthesiology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan; (T.S.); (M.I.); (M.K.)
| | - Nobuhiro Tanaka
- Department of Anesthesiology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan; (T.S.); (M.I.); (M.K.)
| | - Yuma Kadoya
- Department of Anesthesiology, Ikeda City Hospital, 3-1-18 Jonan, Ikeda 635-8501, Osaka, Japan;
| | - Mitsuru Ida
- Department of Anesthesiology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan; (T.S.); (M.I.); (M.K.)
| | - Masato Iwata
- Department of Anesthesiology, Yamatotakada Municipal Hospital, 1-1, Isonokita-cho, Yamatotakada 635-8501, Nara, Japan;
| | - Naoki Ozu
- Institute for Clinical and Translational Science, Nara Medical University Hospital, 840 Shijocho, Kashihara 634-8522, Nara, Japan;
| | - Masahiko Kawaguchi
- Department of Anesthesiology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan; (T.S.); (M.I.); (M.K.)
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Ökmen K. Ultrasound-guided external oblique and rectus abdominis plane "EXORA" block for postoperative pain after laparoscopic cholecystectomy: a propensity-matched study. Minerva Anestesiol 2023; 89:1074-1081. [PMID: 37851417 DOI: 10.23736/s0375-9393.23.17524-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
BACKGROUND Various types of plane blocks are used for analgesia in the upper abdomen. The purpose of this study was to evaluate the efficacy of the external oblique and rectus abdominis plane (EXORA) block for antero-lateral upper abdominal analgesia. METHODS This study included 60 patients undergoing laparoscopic cholecystectomy. Patients were divided into control group, intravenous patient-controlled analgesia (IV.PCA) (N.=30) and EXORA group (block with 25 mL 0.25% bupivacaine + IV.PCA [N.=30]). Postoperative pain (at rest) was evaluated at 30 minutes, two, four, six, 12 and 24 hours using Visual Analogue Scale (VAS) scores. Postoperative activity pain at two, four, six, 12 and 24 hours was also assessed using VAS. Secondary outcomes included tramadol use at 12 and 24 hours after surgery, side effect profile, dermatomal spread, and additional analgesic use. RESULTS The VAS scores were statistically significantly lower in the EXORA group compared to the other groups (P<0.001). In addition, mean tramadol consumption at 12 and 24 hours was statistically significantly lower in the EXORA group (P<0.001). Sensory block was recorded in the lateral and anterior abdomen at T6 to T11 after EXORA block application. CONCLUSIONS The EXORA block used to provide analgesia after laparoscopic cholecystectomy provides analgesia to the upper abdominal wall. Further data may be obtained from cadaveric studies and other studies.
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Affiliation(s)
- Korgün Ökmen
- Department of Anesthesiology and Reanimation, Bursa Yuksek Ihtisas Training and Research Hospital, University of Health Sciences, Bursa, Türkiye - korgunokmen @gmail.com
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Çiftçi B, Güngör H, Alver S, Nurmen Akın A, Özdenkaya Y, Tulgar S. Clinical Experience for Modified Thoracoabdominal Nerve Block Through Perichondrial Approach (M-TAPA) in Five Patients. Dermatomal Evaluation and Application of Different Volumes: A Case Series and Review of Literature. Turk J Anaesthesiol Reanim 2023; 51:354-357. [PMID: 37587679 PMCID: PMC10440489 DOI: 10.4274/tjar.2022.221042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 12/21/2022] [Indexed: 08/18/2023] Open
Abstract
Thoracoabdominal nerves block through perichondrial approach (TAPA) is a novel block and provides abdominal analgesia. TAPA block targets the both anterior and the lateral branches of the thoracoabdominal nerves. Modified-TAPA (M-TAPA) was defined due to the need for blocking certain dermatomes depending on the surgical incision sites. In the literature, the knowledge about the efficiency and dermatomal coverage of M-TAPA is limited. In this case series, we want to report our experiences with this issue.
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Affiliation(s)
- Bahadır Çiftçi
- Department of Anaesthesiology and Reanimation, İstanbul Medipol University, Mega Medipol University Hospital, İstanbul, Turkey
| | - Hande Güngör
- Department of Anaesthesiology and Reanimation, İstanbul Medipol University, Mega Medipol University Hospital, İstanbul, Turkey
| | - Selçuk Alver
- Department of Anaesthesiology and Reanimation, İstanbul Medipol University, Mega Medipol University Hospital, İstanbul, Turkey
| | - Ayşe Nurmen Akın
- Department of Anaesthesiology and Reanimation, İstanbul Medipol University, Mega Medipol University Hospital, İstanbul, Turkey
| | - Yaşar Özdenkaya
- Department of General Surgery, İstanbul Medipol University, Mega Medipol University Hospital, İstanbul, Turkey
| | - Serkan Tulgar
- Department of Anaesthesiology and Reanimation, Samsun University Faculty of Medicine, Samsun Training and Research Hospital, Samsun, Turkey
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Ohgoshi Y, Mizuguchi-Tate A, Kawagoe I. External oblique muscle plane blocks in combination with modified thoracoabdominal nerves block through perichondrial approach for analgesia in abdominal surgery: A case report. Saudi J Anaesth 2023; 17:413-415. [PMID: 37601492 PMCID: PMC10435807 DOI: 10.4103/sja.sja_807_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 11/19/2022] [Indexed: 08/22/2023] Open
Abstract
The costal and lateral external oblique muscle plane (EXOP) blocks anesthetize the lateral cutaneous branches, whereas the modified thoracoabdominal nerves block through perichondrial approach (M-TAPA) anesthetizes the anterior branches of the thoracoabdominal nerves. Herein, we report two cases of successful perioperative pain management with the combination of these blocks: case 1 was a 67-year-old man who underwent open cholecystectomy and case 2 was a 38-year-old woman who underwent emergency laparoscopic surgery for strangulation ileus. Both patients were administered the costal and/or lateral EXOP blocks along with bilateral M-TAPA for perioperative analgesia. A pin-prick test performed 1 h after surgery revealed that the cutaneous sensory block covered all areas of the abdominal surgical field. Combined use of these blocks can be a new local analgesic strategy for abdominal surgery.
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Affiliation(s)
- Yuichi Ohgoshi
- Department of Anesthesiology, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama, Kanagawa, Japan
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, Japan
| | - Aki Mizuguchi-Tate
- Department of Anesthesiology, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama, Kanagawa, Japan
| | - Izumi Kawagoe
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, Japan
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Ohgoshi Y, Kawagoe I, Anetai H, Ichimura K. Injectate spread after superficial injection of thoracoabdominal nerves block through the perichondrial approach. Can J Anaesth 2023; 70:1266-1267. [PMID: 37226014 DOI: 10.1007/s12630-023-02485-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 12/18/2022] [Accepted: 12/31/2022] [Indexed: 05/26/2023] Open
Affiliation(s)
- Yuichi Ohgoshi
- Department of Anaesthesiology, Keiyu Hospital, Kanagawa, Japan.
- Department of Anaesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan.
| | - Izumi Kawagoe
- Department of Anaesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Hidaka Anetai
- Department of Anatomy and Life Structure, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Koichiro Ichimura
- Department of Anatomy and Life Structure, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Matsuura H, Terada Y, Rokkaku Y, Tamagawa H, Taniguchi E, Saito Y, Tsujimura N, Tanaka N, Kawaguchi M. Analgesic efficacy of modified thoracoabdominal nerves block through the perichondrial approach in laparoscopic cholecystectomy: A retrospective study with propensity analysis. Asian J Endosc Surg 2023. [PMID: 36958288 DOI: 10.1111/ases.13183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/01/2023] [Accepted: 03/08/2023] [Indexed: 03/25/2023]
Abstract
Modified thoracoabdominal nerves block through the perichondral approach (M-TAPA) was recently reported to provide broad analgesia with only a single injection of local anesthetics (LA) on each side. However, the effectiveness of M-TAPA in laparoscopic cholecystectomy (LC) is not often reported. We retrospectively evaluated the analgesic efficacy of M-TAPA in patients who underwent LC and compared it with conventional LA infiltration (LAI) by calculating the propensity score. The primary outcome was the frequency of analgesic use after surgery. Although there was no difference in the frequency of analgesic use within 48 hours (P = .063), there was significantly less analgesic use 24-48 hours after surgery in the TAPA group (P = .02). Intraoperative remifentanil administration also significantly decreased in the TAPA group (P < .001). We found that pre-incisional M-TAPA may have an advantage over LAI with respect to analgesia on postoperative day 1.
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Affiliation(s)
- Hideki Matsuura
- Department of Anesthesiology, Otemae Hospital, Osaka, Japan
- Department of Anesthesiology, Nara Medical University, Nara, Japan
| | - Yuki Terada
- Department of Anesthesiology, Otemae Hospital, Osaka, Japan
- Department of Anesthesiology, Nara Medical University, Nara, Japan
| | - Yuki Rokkaku
- Department of Anesthesiology, Otemae Hospital, Osaka, Japan
| | | | | | - Yurina Saito
- Department of Surgery, Otemae Hospital, Osaka, Japan
| | | | - Nobuhiro Tanaka
- Department of Anesthesiology, Nara Medical University, Nara, Japan
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Güngör H, Ciftci B, Alver S, Gölboyu BE, Ozdenkaya Y, Tulgar S. Modified thoracoabdominal nerve block through perichondrial approach (M-TAPA) vs local infiltration for pain management after laparoscopic cholecystectomy surgery: a randomized study. J Anesth 2022; 37:254-260. [PMID: 36575362 DOI: 10.1007/s00540-022-03158-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/18/2022] [Indexed: 12/29/2022]
Abstract
PURPOSE Modified 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. METHODS Patients 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. RESULTS The 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). CONCLUSION M-TAPA provides superior analgesia compared to LI in patients undergoing LC.
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Affiliation(s)
- Hande Güngör
- Department of Anesthesiology and Reanimation, Istanbul Medipol University, Bagcilar, 34040, Istanbul, Turkey
| | - Bahadir Ciftci
- Department of Anesthesiology and Reanimation, Istanbul Medipol University, Bagcilar, 34040, Istanbul, Turkey.
| | - Selcuk Alver
- Department of Anesthesiology and Reanimation, Istanbul Medipol University, Bagcilar, 34040, Istanbul, Turkey
| | | | - Yasar Ozdenkaya
- Department of General Surgery, Istanbul Medipol University, Istanbul, Turkey
| | - Serkan Tulgar
- Faculty of Medicine, Department of Anesthesiology and Reanimation, Samsun University, Samsun Training and Research Hospital, Samsun, Turkey
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Fascial plane blocks: moving from the expansionist to the reductionist era. Can J Anaesth 2022; 69:1185-1190. [PMID: 35999333 DOI: 10.1007/s12630-022-02309-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 06/17/2022] [Accepted: 07/13/2022] [Indexed: 01/12/2023] Open
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