Istanbul Medipol University, Department of Anesthesiology and Reanimation, Istanbul, Turkey.
Istanbul Medipol University, School of Medicine, Department of Anesthesiology and Reanimation, Istanbul, Turkey.
Braz J Anesthesiol. 2023 Sep-Oct;73(5):595-602. doi: 10.1016/j.bjane.2023.05.001. Epub 2023 May 16.
Modified thoracoabdominal nerve block through perichondrial approach is a novel fascial plane block and provides abdominal analgesia by blocking thoracoabdominal nerves. Our primary aim was to evaluate the efficacy of M-TAPA on quality of recovery and pain scores in patients who underwent laparoscopic inguinal hernia repair surgery (Trans Abdominal Pre-Peritoneal approach ‒ TAPP).
Patients with American Society of Anesthesiologists (ASA) physical status I-II aged between 18 and 65 years scheduled for elective TAPP under general anesthesia were enrolled in the study. After intubation, the patients were randomized into two groups: M: M-TAPA group (n = 30) and the control group (n = 30). M-TAPA was performed with total 40 ml 0.25% bupivacaine in the M group. Surgical infiltration was performed in the control group. The primary outcome of the study was the global quality of recovery score, the secondary outcomes were pain scores, rescue analgesic demands, and adverse effects during the 24-h postoperative period.
The global quality of recovery scores at 24 h were significantly higher in the M group (p < 0.001). There was a reduction in the median static and dynamic NRS for the first postoperative 8 h in the M group compared to the control group (p < 0.001). The need for rescue analgesia was significantly lower in the M group compared to the control group (13 patients vs. 24 respectively, p < 0.001). The incidence of side effects was significantly higher in the control group (p < 0.001).
In our study, M-TAPA increased patient recovery scores, and provided pain relief in patients who underwent TAPP.
NCT05199922.
改良经软骨膜胸腹神经阻滞是一种新的筋膜平面阻滞技术，通过阻滞胸腹神经提供腹部镇痛。我们的主要目的是评估 M-TAPA 在接受腹腔镜腹股沟疝修补术（经腹腹膜前入路 - TAPP）的患者中对恢复质量和疼痛评分的疗效。
纳入了年龄在 18 至 65 岁之间、ASA 身体状况 I-II 级、接受全身麻醉下择期 TAPP 的患者。插管后，患者随机分为两组：M：M-TAPA 组（n=30）和对照组（n=30）。M 组行 M-TAPA，共注入 40ml0.25%布比卡因。对照组行手术浸润。研究的主要结局是总体恢复质量评分，次要结局是疼痛评分、解救性镇痛需求以及术后 24 小时内的不良反应。
M 组在术后 24 小时的总体恢复质量评分显著更高（p<0.001）。与对照组相比，M 组在术后 8 小时内的静态和动态 NRS 中位数均降低（p<0.001）。与对照组相比，M 组需要解救性镇痛的患者明显更少（分别为 13 例和 24 例，p<0.001）。对照组的不良反应发生率显著更高（p<0.001）。
在我们的研究中，M-TAPA 提高了 TAPP 患者的恢复评分，并提供了疼痛缓解。
NCT05199922。
