Ultrasound Guided M-Tapa Block for Postoperative Analgesia Management in Patients Underwent Laparoscopic Inguinal Hernia Repair Surgery

Medipol University1 site in 1 country60 target enrollmentJanuary 19, 2022

Overview

Brief Summary

Modified Perichondral Approach Thoracoabdominal Nerve (M-TAPA) block is a novel block that provides effective analgesia of the anterior and lateral thoracoabdominal walls during laparoscopic surgery, in which local anesthetic is applied only to the lower side of the perichondral surface. M-TAPA block is a good alternative for analgesia of the upper dermatome levels and the abdominal lateral wall, and may be an opioid-sparing strategy with satisfactory quality improvement in patients undergoing laparoscopic surgery.

M-TAPA block provides analgesia at the level of T5-T11 in the abdominal region. Sonoanatomy is easy to visualize and the spread of local anesthetic can be easily seen. Analgesia occurs in several dermatomes thanks to the cephalocaudal spread of the local anesthetic solution. There are studies in the literature investigating the effectiveness of M-TAPA block for post-operative pain management in several abdominal surgeries.

Detailed Description

Modified Perichondral Approach Thoracoabdominal Nerve (M-TAPA) block is a novel block that provides effective analgesia of the anterior and lateral thoracoabdominal walls during laparoscopic surgery, in which local anesthetic is applied only to the lower side of the perichondral surface. M-TAPA block is a good alternative for analgesia of the upper dermatome levels and the abdominal lateral wall, and may be an opioid-sparing strategy with satisfactory quality improvement in patients undergoing laparoscopic surgery. M-TAPA block provides analgesia at the level of T5-T11 in the abdominal region. Sonoanatomy is easy to visualize and the spread of local anesthetic can be easily seen. Analgesia occurs in several dermatomes thanks to the cephalocaudal spread of the local anesthetic solution. There are studies in the literature investigating the effectiveness of M-TAPA block for post-operative pain management in several abdominal surgeries. In this study, we aimed to evaluate the effectiveness of M-TAPA block for postoperative analgesia management after laparoscopic inguinal hernia repair surgery. Our primary aim is to compare the postoperative pain scores (NRS), and our secondary aim is to compare the postoperative rescue analgesic use and postoperative opioid consumption, and the side effects (allergic reaction, nausea, vomiting) associated with opioid use.

Registry

clinicaltrials.gov

Start Date

January 19, 2022

End Date

July 20, 2022

Last Updated

3 years ago

Study Type

Interventional

Study Design

Parallel

Sex

All

Investigators

Sponsor

Medipol University

Responsible Party

Principal Investigator

Bahadir Ciftci

Primary researcher

Medipol University

Eligibility Criteria

Inclusion Criteria

•American Society of Anesthesiologists (ASA) classification I-II
•Scheduled for laparoscopic inguinal hernia repair surgery under general anesthesia

Exclusion Criteria

•Bleeding diathesis
•Receiving anticoagulant treatment
•Known local anesthetics and opioid allergy
•Infection of the skin at the site of the needle puncture
•Pregnancy or lactation
•Patients who do not accept the procedure

Arms & Interventions

Group M = M-TAPA group

Patients will be administered ibuprofen 400 mgr IV every 8 hours in the postoperative period. Postoperative patient evaluation will be performed by a pain nurse blinded to the procedure. 100 mg tramadol will be performed for rescue analgesia.

Intervention: M TAPA block

Outcomes

Primary Outcomes

Global recovery scoring system (patient satisfaction scale)

Time Frame: Change from baseline score at postoperative 24 hour

This scoring system includes evaluating emotional state (12 questions), physical comfort (12 questions), psychological support (7 questions), physical independence (12 questions), and pain (7 questions).