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Comparison of Ultrasound-Guided Erector Spinae Plane Block and Modified Thoracoabdominal Nerve Block Through Perichondrial Approach (M-TAPA) for Postoperative Analgesia After Laparoscopic Cholecystectomy: A Randomized Controlled Study
Sponsor: Saglik Bilimleri Universitesi
Summary
This study compared two ultrasound-guided regional anesthesia techniques for pain relief after laparoscopic gallbladder surgery: the modified thoracoabdominal nerve block through a perichondrial approach and the erector spinae plane block. Adults undergoing elective laparoscopic cholecystectomy under general anesthesia were randomly assigned to receive one of these two nerve blocks on both sides of the body before awakening from anesthesia. Both techniques used bupivacaine as the local anesthetic. After surgery, pain intensity, tramadol consumption, need for additional pain medication, nausea and vomiting, antiemetic use, and block-related complications were assessed during the first 24 postoperative hours. The main objective was to determine whether the two techniques differed in their ability to reduce postoperative tramadol consumption and provide effective pain relief.
Key Details
Gender
All
Age Range
18 Years - 65 Years
Study Type
INTERVENTIONAL
Enrollment
80
Start Date
2025-02-20
Completion Date
2025-12-02
Last Updated
2026-08-07
Healthy Volunteers
No
Interventions
Bilateral Ultrasound-Guided Modified Thoracoabdominal Nerve Block Through Perichondrial Approach
After removal of the gallbladder and before extubation, the block was performed bilaterally under ultrasound guidance. The external oblique, internal oblique, and transversus abdominis muscles were identified at the inferior margin of the 10th costal cartilage. A block needle was advanced using an in-plane technique toward the inferior surface of the costal cartilage. After confirmation of the needle position with 2 to 3 mL of normal saline, 20 mL of 0.25% bupivacaine was administered on each side.
Bilateral Ultrasound-Guided Erector Spinae Plane Block
After removal of the gallbladder and before extubation, the block was performed bilaterally under ultrasound guidance at the T7 vertebral level. The needle was advanced using an in-plane technique until its tip was positioned between the erector spinae muscle and the transverse process. After confirmation of the needle position with 2 to 3 mL of normal saline, 20 mL of 0.25% bupivacaine was administered on each side.
Locations (1)
Istanbul Provincial Directorate of Health Sultan 2.Abdul Hamid Khan Educational and Research Hospital
Istanbul, Turkey (Türkiye)