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Comparison of M-TAPA, EOIP, and Local Infiltration for Pain Relief After Laparoscopic Cholecystectomy
Sponsor: Pamukkale University
Summary
This retrospective observational study aimed to compare three pain management techniques used after laparoscopic gallbladder removal (cholecystectomy): modified thoracoabdominal nerve block through the perichondrial approach (M-TAPA), external oblique intercostal plane (EOIP) block, and local anesthetic infiltration. The study included 90 adult patients who underwent elective laparoscopic cholecystectomy between January and April 2025. Patients were divided into three groups according to the pain management technique they received during routine clinical care, with 30 patients in each group. The primary outcome was pain intensity measured 2 hours after surgery using a visual analog scale (VAS). Additional outcomes included pain scores at 15 minutes and 4, 8, 16, and 24 hours after surgery, the need for additional opioid pain medication, and opioid-related adverse events. The study aimed to evaluate differences in postoperative pain control and the need for additional pain medication among these three techniques using previously collected medical records.
Official title: Postoperative Analgesic Efficacy of M-TAPA and External Oblique Intercostal Plane Blocks Versus Local Infiltration in Laparoscopic Cholecystectomy: A Retrospective Cohort Study
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
OBSERVATIONAL
Enrollment
90
Start Date
2025-01-14
Completion Date
2025-04-16
Last Updated
2026-10-19
Healthy Volunteers
No
Conditions
Interventions
Modified Thoracoabdominal Nerve Block Through the Perichondrial Approach
Bilateral ultrasound-guided modified thoracoabdominal nerve block through the perichondrial approach (M-TAPA) was performed after completion of laparoscopic cholecystectomy. Under sterile conditions, 20 mL of 0.25% bupivacaine was injected on each side into the fascial plane between the transversus abdominis muscle and the costochondral structure, for a total volume of 40 mL. The procedure was performed as part of routine clinical care.
External Oblique Intercostal Plane Block
Bilateral ultrasound-guided external oblique intercostal plane (EOIP) block was performed after completion of laparoscopic cholecystectomy. Under sterile conditions, 20 mL of 0.25% bupivacaine was injected on each side into the fascial plane between the external oblique and intercostal muscles at the level of the sixth and seventh ribs, for a total volume of 40 mL. The procedure was performed as part of routine clinical care.
Local anesthetic infiltration
Local anesthetic infiltration was performed by the surgeon at the end of laparoscopic cholecystectomy. A total of 20 mL of 0.50% bupivacaine was administered around the four laparoscopic port sites, with approximately 5 mL injected at each site. The procedure was performed as part of routine clinical care.
Locations (1)
Pamukkale University Hospital
Merkezefendi, Denizli, Turkey (Türkiye)