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Analgesic efficacy of modified thoracoabdominal nerves block through the perichondrial approach in laparoscopic

Hideki Matsuura1,2, Yuki Terada1,2, Yuki Rokkaku1

  • 1Department of Anesthesiology, Otemae Hospital, Osaka, Japan.

Asian Journal of Endoscopic Surgery
|March 23, 2023
PubMed

Insights

Modified thoracoabdominal nerves block through the perichondral approach (M-TAPA) offers effective pain relief after laparoscopic cholecystectomy. This nerve block reduced analgesic use on postoperative day one compared to local anesthetic infiltration.

Area of Science:

  • Anesthesiology
  • Surgical Pain Management

Background:

  • Modified thoracoabdominal nerves block through the perichondral approach (M-TAPA) provides broad analgesia with a single local anesthetic (LA) injection.
  • The efficacy of M-TAPA for laparoscopic cholecystectomy (LC) requires further investigation.

Purpose of the Study:

  • To evaluate the analgesic efficacy of M-TAPA in patients undergoing LC.
  • To compare M-TAPA with conventional local anesthetic infiltration (LAI) using propensity score matching.

Main Methods:

  • Retrospective evaluation of analgesic efficacy in LC patients.
  • Propensity score matching to compare M-TAPA and LAI groups.
  • Primary outcome: frequency of analgesic use within 48 hours post-surgery.

Main Results:

  • No significant difference in analgesic use within the first 48 hours (P=0.063).
  • Significantly reduced analgesic use between 24-48 hours in the M-TAPA group (P=0.02).
  • Reduced intraoperative remifentanil administration in the M-TAPA group (P<0.001).

Conclusions:

  • Pre-incisional M-TAPA demonstrates an advantage over LAI for postoperative day 1 analgesia in LC.
  • M-TAPA may improve pain management and reduce opioid requirements after laparoscopic cholecystectomy.
Keywords:
laparoscopic cholecystectomymodified thoracoabdominal nerves block through the perichondral approach (M-TAPA)pre-emptive analgesia

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