A Comparison of Two Fascial Plane Blocks for Abdominal Analgesia in Laparoscopic Cholecystectomy Surgery (M-TAPA vs. External Oblique Intercostal Plane Block): A Prospective Randomized Study

<b>Background:</b> Modified thoracoabdominal nerve block through a perichondrial approach (M-TAPA) and external oblique intercostal plane block (EOIB) provide abdominal analgesia by blocking thoracoabdominal nerves. Our aim was to compare the analgesic efficacy of M-TAPA vs. EOIB on the quality of recovery and pain scores in patients who underwent laparoscopic cholecystectomy surgery (LC). <b>Methods:</b> Patients with American Society of Anesthesiologists status I-II, aged between 18 and 65 years, and scheduled for elective LC under general anesthesia were enrolled in the study. The patients were randomized into two groups: Group M-TAPA (<i>n</i> = 30) and Group EOIB (<i>n</i> = 30). The blocks were performed with 40 mL 0.25% bupivacaine in total. The primary outcome of the study was the global quality of recovery score, and the secondary outcomes were the pain scores, rescue analgesic requirement, and adverse effects during the 24-h postoperative period. <b>Results:</b> The global quality of recovery scores at 24 h were similar in both groups. There was a reduction in the median static and dynamic numerical rating scale (NRS) in the first 2 h postoperatively for M-TAPA compared to the EOIB (<i>p</i> < 0.001). The need for rescue analgesia was significantly lower in the M-TAPA group compared to the EOIB group (<i>p</i> < 0.005). <b>Conclusions:</b> Opioid consumption was lower in the M-TAPA group, and the pain scores of the two groups were similar, with the exception of the first 2 h postoperatively. Both the M-TAPA block and EOIB are effective for analgesia following laparoscopic abdominal surgeries.

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Publication Details

Journal
Journal of Clinical Medicine
Published
2025-04-28
DOI
https://doi.org/10.3390/jcm14093050
Citations
4
Primary Topic
Anesthesia and Pain Management
Type
article
Field-Weighted Citation Impact
8.03
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article

A Comparison of Two Fascial Plane Blocks for Abdominal Analgesia in Laparoscopic Cholecystectomy Surgery (M-TAPA vs. External Oblique Intercostal Plane Block): A Prospective Randomized Study

Alessandro De Cassai, Birzat Emre Gölboyu, Hacı Ahmet Alici, Mustafa Celalettin Haksal et al.
4 citations
Journal of Clinical Medicine
Anesthesia and Pain Management
8.03
article

A Comparison of Two Fascial Plane Blocks for Abdominal Analgesia in Laparoscopic Cholecystectomy Surgery (M-TAPA vs. External Oblique Intercostal Plane Block): A Prospective Randomized Study

Alessandro De Cassai, Birzat Emre Gölboyu, Hacı Ahmet Alici, Mustafa Celalettin Haksal, Selçuk Alver, Serkan Tulgar, Bahadır Çiftçi
article en
4 citations

Abstract

<b>Background:</b> Modified thoracoabdominal nerve block through a perichondrial approach (M-TAPA) and external oblique intercostal plane block (EOIB) provide abdominal analgesia by blocking thoracoabdominal nerves. Our aim was to compare the analgesic efficacy of M-TAPA vs. EOIB on the quality of recovery and pain scores in patients who underwent laparoscopic cholecystectomy surgery (LC). <b>Methods:</b> Patients with American Society of Anesthesiologists status I-II, aged between 18 and 65 years, and scheduled for elective LC under general anesthesia were enrolled in the study. The patients were randomized into two groups: Group M-TAPA (<i>n</i> = 30) and Group EOIB (<i>n</i> = 30). The blocks were performed with 40 mL 0.25% bupivacaine in total. The primary outcome of the study was the global quality of recovery score, and the secondary outcomes were the pain scores, rescue analgesic requirement, and adverse effects during the 24-h postoperative period. <b>Results:</b> The global quality of recovery scores at 24 h were similar in both groups. There was a reduction in the median static and dynamic numerical rating scale (NRS) in the first 2 h postoperatively for M-TAPA compared to the EOIB (<i>p</i> < 0.001). The need for rescue analgesia was significantly lower in the M-TAPA group compared to the EOIB group (<i>p</i> < 0.005). <b>Conclusions:</b> Opioid consumption was lower in the M-TAPA group, and the pain scores of the two groups were similar, with the exception of the first 2 h postoperatively. Both the M-TAPA block and EOIB are effective for analgesia following laparoscopic abdominal surgeries.

Journal of Clinical MedicineVol. 14(9)
University of Padua (IT), Izmir Kâtip Çelebi University (TR), Istanbul Medipol University (TR), Samsun University (TR)
Openalex Percentile: Top 3%
Anesthesia and Pain Management
8.03
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