Effectiveness of Thoracoabdominal Nerve Block (M-TAPA) on Postoperative Pain Relief in Laparoscopic Hysterectomy

N/ANot Yet RecruitingNCT07483190

Istinye University60 enrolled

Overview

This study aims to investigate the effectiveness of a specific regional anesthesia technique, the Modified-Thoracoabdominal Nerve Block through a Perichondrial Approach (M-TAPA), on reducing pain after laparoscopic hysterectomy surgery. Hysterectomy is a common major surgical procedure, and managing postoperative pain is crucial for patient comfort and faster recovery. Participants will be randomly assigned to one of two groups: The M-TAPA Group: Patients will receive the nerve block using a local anesthetic (bupivacaine) before the surgery begins. The Control Group: Patients will receive standard postoperative pain management without the nerve block. The primary goal is to determine if the M-TAPA block reduces the total amount of opioid (morphine) used by patients in the first 24 hours after surgery. The researchers will also evaluate pain scores (NRS), the time until the first request for additional pain medication, patient satisfaction, and any side effects like nausea or vomiting

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

DOUBLE

Enrollment

Conditions

Postoperative Pain Hysterectomy Plane Blocks

Interventions

Modified-Thoracoabdominal Nerve Block through a Perichondrial Approach (M-TAPA)PROCEDURE

Under ultrasound guidance, a 22-gauge peripheral block needle is inserted at the costochondral angle (9th-10th ribs). After confirming the position, 20 ml of 0.25% bupivacaine is injected bilaterally into the lower part of the chondrium.

Eligibility

Sex: FEMALEMin age: 18 YearsMax age: 70 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Aged between 18 and 70 years * ASA (American Society of Anesthesiologists) physical status I, II, or III * Scheduled for elective laparoscopic hysterectomy * Voluntary participation with signed informed consent Exclusion Criteria: * Hepatic or renal disease. * Coagulation disorders. * Uncontrolled cardiovascular or respiratory diseases. * Psychiatric disorders. * History of allergy to local anesthetics. * History of alcoholism, drug or substance abuse. * Body Mass Index (BMI) greater than 35 kg/m2 * Refusal of the regional block procedure

Outcomes

Primary Outcomes

Morphine consumption

Total amount of morphine (mg) used via Patient-Controlled Analgesia (PCA)

Time frame: First 24 hours postoperatively

Secondary Outcomes

Postoperative Pain Scores (NRS)

Numerical Rating Scale (0=no pain, 10=worst pain)

Time frame: Baseline (Hour 0), 1, 2, 4, 6, 12, and 24 hours postoperatively

Rescue analgesic drug consumption

The amount of rescue analgesic in mg required by the patient will be recorded for the first 24 hours.

Time frame: Within the first 24 hours postoperatively

Incidence of postoperative nausea and vomiting

Number of patients developing postoperative nausea and vomiting will be recorded for the first 24 hours