Evaluation of the efficacy of M-TAPA and EXORA block application for analgesia after laparoscopic cholecystectomy: a prospective, single-blind, observational study
Korean Journal of Anesthesiology, cilt.78, sa.4, ss.361-368, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 78 Sayı: 4
- Basım Tarihi: 2025
- Doi Numarası: 10.4097/kja.24563
- Dergi Adı: Korean Journal of Anesthesiology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Directory of Open Access Journals
- Sayfa Sayıları: ss.361-368
- Anahtar Kelimeler: Abdominal wall, Analgesia, Cholecystectomy, laparoscopic, Nerve block, Pain, postoperative, Ultrasonography
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Different field block methods are used for analgesia following abdominal surgery. In this study, we evaluated the efficacy of a modified thoracoabdominal nerve block via the perichondrial approach (M-TAPA) and that of an external oblique and rectus abdominis plane (EXORA) block for anterolateral upper abdominal analgesia. Methods: This study included 90 patients undergoing laparoscopic cholecystectomy. Patients were divided into three groups (n = 30 per group): a control group, which received intravenous patient-controlled analgesia (IV-PCA); an EXORA block group, which received an EXORA block with 0.25% bupivacaine + IV-PCA; and an M-TAPA block group, which received an M-TAPA with 0.25% bupivacaine + IV-PCA. The primary outcome was postoperative pain (at rest and on movement), evaluated using numerical rating scale (NRS) scores at 2, 4, 6, 12, and 24 h postoperatively. Secondary outcomes included tramadol use, the side effect profile, dermatomal spread, and additional analgesic use at 12 h and 24 h postoperatively. Results: NRS scores as well as the mean tramadol consumption at 12 h and 24 h postoperatively were significantly lower in the EXORA and M-TAPA groups than in the control group (all P < 0.001). Sensory block was recorded in the lateral and anterior abdomen from T7 to T11 after both EXORA block and M-TAPA application. Conclusions: EXORA block and M-TAPA application provided similar levels of analgesia to the upper abdominal wall after laparoscopic cholecystectomy. Further data should be obtained from cadaveric and other types of studies.