Comparison of M-TAPA and EOIB to TAP Block in Laparoscopic Cholecystectomy: A Single-Blind Randomized Controlled...

Laparoscopic cholecystectomy (LC) is one of the most common abdominal surgeries, requiring perioperative pain management for early recovery. Modified thoracoabdominal nerves block through perichondral approach (M-TAPA) and external oblique intercostal block (EOIB) have been reported to be effective in achieving analgesia for upper abdominal surgery. However, the efficacy of M-TAPA and EOIB in LC is still limited. We prospectively evaluated the efficacy of M-TAPA and EOIB as alternatives to the transversus abdominis plane (TAP) block.

Fifty patients were randomly assigned to one of three groups: TAP, M-TAPA, or EOIB. The primary outcome was the static pain score at 12 hours postoperatively. The secondary outcomes were postoperative pain scores, rescue narcotic use, time spent on nerve block, presence of complications, and postoperative Quality of Recovery-15 scores.

Forty-one patients were included in this study. No significant difference in static Numeric Rating Scale score at 12 h postoperatively was found between the TAP and M-TAPA (p = 0.55) or EOIB (p = 0.071). The nerve block duration was shorter in the M-TAPA group (p = 0.011).

Compared with TAP block, neither M-TAPA nor EOIB showed significant differences in static pain assessment at 12 h after surgery in LC.