Postoperative Analgesic Efficacy Of Modified-Thoracoabdominal Nerves Block Through Perichondrial Approach And Transversus Abdominis Plane Block In Patients Undergoing Open Hysterectomy With Bilateral Salpingo-Oophorectomy: A Randomized-Controlled Stu

INTRODUCTION: This study aimed to compare the postoperative analgesic effect of modified-thoracoabdominal nerves block through perichondrial approach (M-TAPA) and transversus abdominis plane (TAP) block in patients who underwent open hysterectomy with bilateral salpingo-oophorectomy. METHODS: This study is a single-center, open label, prospective, randomized-controlled trial. Patients were divided into three groups: Group Control (n=15), Group M-TAPA (n=15) and Group TAP (n=15). Group M-TAPA and Group TAP patients received a bilateral M-TAPA and bilateral lateral-TAP blocks under ultrasound guidance with the use of bupivacaine 0.25% with a standard dose of 20 ml for each side. The primary outcome was the numerical rating scale (NRS) scores of the patients. Secondary outcome was total tramadol consumption by the patients followed up for postoperative 24 hours. RESULTS: When the groups were compared in terms of static and dynamic NRS scores, there was a statistically significant difference between Group Control and the other groups (p<0.05). There was no statistically significant difference between Group M-TAPA and Group TAP in terms of NRS scores at all times (p>0.05). Total tramadol consumption was higher in Group Control (p<0.05) while there was no statistically significant difference between Group M-TAPA and Group TAP (p>0.05). DISCUSSION AND CONCLUSION: In this study, although no statistically significant difference in analgesic efficacy was found between M-TAPA and TAP blocks after open TAH+BSO surgeries, both techniques provided clinically acceptable analgesia compared to the control group.