Ciftci Bahadir, Alver Selcuk, Gölboyu Birzat Emre, Haksal Mustafa Celalettin, Tulgar Serkan, De Cassai Alessandro, Alici Haci Ahmet
Department of Anesthesiology and Reanimation, Istanbul Medipol University, Istanbul 34214, Turkey.
Department of Anatomy, Istanbul Medipol University, Istanbul 34815, Turkey.
J Clin Med. 2025 Apr 28;14(9):3050. doi: 10.3390/jcm14093050.
Modified thoracoabdominal nerve block through a perichondrial approach (M-TAPA) and external oblique intercostal plane block (EOIB) provide abdominal analgesia by blocking thoracoabdominal nerves. Our aim was to compare the analgesic efficacy of M-TAPA vs. EOIB on the quality of recovery and pain scores in patients who underwent laparoscopic cholecystectomy surgery (LC). Patients with American Society of Anesthesiologists status I-II, aged between 18 and 65 years, and scheduled for elective LC under general anesthesia were enrolled in the study. The patients were randomized into two groups: Group M-TAPA ( = 30) and Group EOIB ( = 30). The blocks were performed with 40 mL 0.25% bupivacaine in total. The primary outcome of the study was the global quality of recovery score, and the secondary outcomes were the pain scores, rescue analgesic requirement, and adverse effects during the 24-h postoperative period. The global quality of recovery scores at 24 h were similar in both groups. There was a reduction in the median static and dynamic numerical rating scale (NRS) in the first 2 h postoperatively for M-TAPA compared to the EOIB ( < 0.001). The need for rescue analgesia was significantly lower in the M-TAPA group compared to the EOIB group ( < 0.005). Opioid consumption was lower in the M-TAPA group, and the pain scores of the two groups were similar, with the exception of the first 2 h postoperatively. Both the M-TAPA block and EOIB are effective for analgesia following laparoscopic abdominal surgeries.
经软骨膜入路改良胸腹神经阻滞（M-TAPA）和腹外斜肌肋间平面阻滞（EOIB）通过阻滞胸腹神经提供腹部镇痛。我们的目的是比较M-TAPA与EOIB对接受腹腔镜胆囊切除术（LC）患者恢复质量和疼痛评分的镇痛效果。纳入美国麻醉医师协会身体状况分级为I-II级、年龄在18至65岁之间、计划在全身麻醉下进行择期LC的患者。患者被随机分为两组：M-TAPA组（n = 30）和EOIB组（n = 30）。总共使用40 mL 0.25%布比卡因进行阻滞。该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、补救性镇痛需求以及术后24小时内的不良反应。两组在术后24小时的总体恢复质量评分相似。与EOIB组相比，M-TAPA组术后前2小时的静态和动态数字评分量表（NRS）中位数有所降低（P < 0.001）。与EOIB组相比，M-TAPA组的补救性镇痛需求显著更低（P < 0.005）。M-TAPA组的阿片类药物消耗量更低，除术后前2小时外，两组的疼痛评分相似。M-TAPA阻滞和EOIB对腹腔镜腹部手术后的镇痛均有效。
