Ultrasound Guided Modified Thoracoabdominal Nerve Block Through Perichondrial Approach (M-TAPA) Versus Quadratus Lumborum Block for Postoperative Analgesia in Laparoscopic Cholecystectomy

Not Applicable

Recruiting

• Conditions: Laparoscopic Cholecystectomy; Modified Thoracoabdominal Nerve Block; Quadratus Lumborum Block
• Interventions: Procedure: Modified thoracoabdominal nerve block through perichondrial approach (M-TAPA); Procedure: Quadratus lumborum block

• Registration Number: NCT06588777
• Lead Sponsor: Ain Shams University

Brief Summary

This study aims to compare the efficacy of using Ultrasound guided modified thoracoabdominal nerve block through perichondrial approach (M-TAPA) versus quadratus lumborum block for postoperative analgesia in laparoscopic cholecystectomy under general anesthesia.

Detailed Description

Not available

Study Timeline

• Study Start: 2024-09-01
• Study First Submitted: 2024-09-01
• Study First Submitted QC: 2024-09-06
• Study First Posted: 2024-09-19
• Status Verified: 2025-01
• Last Update Submitted: 2025-01-18
• Last Update Posted: 2025-01-22
• Primary Completion: 2025-08
• Study Completion: 2025-08

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 52

Inclusion Criteria

• Adult patients aging ≥ 21 years to ≤ 70 of both sexes.
• Patients undergoing Laparoscopic cholecystectomy surgeries.
• ASA physical status classes I - II.

Exclusion Criteria

• Patient's refusal of procedure or participation in the study.
• ASA classes III or above.
• Coagulopathy and bleeding disorders.
• Evidence of Local skin infections at site of injection.
• Body mass index >40kg/m2
• A history of relevant local anesthetic allergy.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Modified thoracoabdominal nerve block through perichondrial approach (M-TAPA)	Modified thoracoabdominal nerve block through perichondrial approach (M-TAPA)	Using the in plane technique A deep angle was given to the costochondral angle at the edge of the 10th costal margin with the probe in the sagittal direction to view the lower surface of the costal cartilage in the midline. A 22-G, 100-mm block needle will be inserted in the cranial direction using the in-plane technique and the needle tip will be moved to the posterior aspect of the 10th costal cartilage. It is noted that the needle tip never crossed the cranial edge of the 10th costal cartilage and 20 mL of 0.25% bupivacaine will be injected into the lower surface of the chondrium to make Modified thoracoabdominal nerve block through perichondrial approach (M-TAPA).
Quadratus lumborum block	Quadratus lumborum block	Using the in plane technique the probe will be placed in the mid-axillary line between the lower costal margin and the iliac crest in a transverse plane to view all abdominal layers. The probe will be moved towards the posterior axillary line, to reach a point where all three abdominal muscle layers merge to form aponeurosis. The aponeurosis will then be followed dorsally until the quadratus lumborum muscle is seen deep to transversalis fascia with its attachment to the transverse process of the L4 vertebral body. A 22 G, 100 mm, blunt, insulated nerve block needle will be inserted 1 cm medial to the probe and advanced using the in-plane technique with ultrasound real-time assessment. The injection site will be the junction of transversalis fascia and the anterolateral border of quadratus lumborum muscle.

Primary Outcome Measures

Name	Time	Method
Time to first Rescue Analgesia	24 hours postoperative	Is to measure the first time to resque analgesia postoperative (24 hours)

Secondary Outcome Measures

Name	Time	Method
The total requirements of rescue analgesia Meperidine (pethidine) over the first 24 hours postoperative	24 hours postoperative
Heart rate	at intervals of 0 (PACU), 1, 2, 4, 6, 12, 18 and 24 hours postoperatively
Blood pressure	at intervals of 0 (PACU), 1, 2, 4, 6, 12, 18 and 24 hours postoperatively
Spo2 measuring	at intervals of 0 (PACU), 1, 2, 4, 6, 12, 18 and 24 hours postoperatively

Trial Locations

Locations (1)

Ainshams university hospitals; 🇪🇬 Cairo, Egypt