Modified Thoracoabdominal Nerves Block Through the Perichondrial Approach vs Subcostal Transversus Abdominis Plane Block for Postoperative Recovery After Laparoscopic Cholecystectomy: A Prospective, Randomized Clinical Trial
Abstract
BACKGROUND This study compared the effects of ultrasound-guided modified thoracoabdominal nerves block through the perichondrial approach (M-TAPA) and subcostal transversus abdominis plane (TAP) block on postoperative recovery after laparoscopic cholecystectomy. MATERIAL AND METHODS Sixty patients aged 18-65 years with American Society of Anesthesiologists physical status I-II undergoing elective laparoscopic cholecystectomy under general anesthesia were included. At the end of surgery, patients were randomly assigned to receive either ultrasound-guided subcostal TAP block (group T, n=30) or M-TAPA block (group M, n=30), with 20 mL of 0.25% bupivacaine administered on each side. Primary outcome was postoperative recovery at 24 hours (Quality of Recovery-15 [QoR-15] questionnaire). Secondary outcomes included postoperative pain scores (numerical rating scale [NRS]) at 0, 2, 4, 8, 16, and 24 hours, rescue analgesic requirements, and postoperative adverse effects. RESULTS The groups were comparable in age, height, weight, duration of surgery, and anesthesia-related variables (all P>0.05). Twenty-four-hour QoR-15 scores were similar between groups (P>0.05). Likewise, NRS pain scores did not differ significantly between groups (P>0.05). Significantly fewer patients required rescue analgesia in group M than in group T (30.0% vs 60.0%, P=0.020). Total rescue analgesic dose did not differ between groups (P=0.943). Postoperative adverse effects were comparable (P>0.05). CONCLUSIONS…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 30 participants or records.
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