TAP and TAPA blocks after laparoscopic cholecystectomy: a randomized double-blind study

Background: Ultrasound-guided fascial plane blocks have become increasingly important for postoperative analgesia following laparoscopic cholecystectomy (LC). This study compared the analgesic effects of the transversus abdominis plane (TAP) block with the thoracoabdominal nerve block performed via a perichondral approach (TAPA) in LC patients. Methods: Sixty-one individuals scheduled for LC under general anesthesia were randomly assigned to receive either a TAP or TAPA block. The duration of block administration was measured. Postoperative pain intensity (Numerical Rating Scale, NRS), tramadol requirements via patient-controlled analgesia (PCA), additional rescue analgesic use, and side effects were evaluated at 2, 6, 12, and 24 hours after surgery. The primary endpoint was 24-h postoperative PCA bolus tramadol dose consumption. Results: The two groups were similar regarding demographic characteristics (p > 0.05), though the TAP group included a higher proportion of male patients (p < 0.05). Performing the TAPA block required more time than TAP (p < 0.05). Tramadol consumption at the 12th hour was significantly lower in the TAPA group, whereas PCA use at other intervals, NRS scores, and rescue analgesic requirements did not differ significantly. Conclusions: Both TAP and TAPA blocks provided effective analgesia after LC. Considering their equivalent efficacy, TAP may be advantageous in clinical practice due to its single injection technique and easier application. Clinical Trial Registration: NCT06768385.