M-TAPA vs OSTAP for Postoperative Analgesia in Laparoscopic Inguinal Hernia

Dr. Lutfi Kirdar Kartal Training and Research Hospital90 enrolled

Overview

This randomized controlled trial aims to compare the postoperative analgesic efficacy of M-TAPA block and OSTAP block in patients undergoing laparoscopic inguinal hernia repair. Pain scores, analgesic consumption, and patient satisfaction will be evaluated.

Prospective, randomized, single-blind, controlled study including 90 patients undergoing elective laparoscopic inguinal hernia repair. Patients will be randomized into three groups: M-TAPA, OSTAP, and control. Postoperative pain scores (VAS), analgesic consumption, time to first analgesic requirement, and patient satisfaction will be assessed over 24 hours.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Inguinal Hernia Bilateral Postoperative Pain

Interventions

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

Ultrasound-guided bilateral M-TAPA block performed with 20 mL of 0.25% bupivacaine per side

Oblique Subcostal Transversus Abdominis Plane Block (OSTAP)PROCEDURE

Ultrasound-guided bilateral OSTAP block performed with 20 mL of 0.25% bupivacaine per side

Standard Analgesia use (paracetamol, contramal)OTHER

Patients received standard postoperative analgesia without regional block

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients aged between 18 and 65 years * American Society of Anesthesiologists (ASA) physical status I-II * Scheduled for elective laparoscopic inguinal hernia repair (TEP technique) * Ability to understand and use the Visual Analog Scale (VAS) * Provided written informed consent Exclusion Criteria: * Refusal to participate or inability to provide informed consent * Age under 18 or over 65 years * ASA physical status ≥ III * Coagulopathy (including abnormal INR, thrombocytopenia, or platelet dysfunction) * Infection at the injection site * Known allergy or hypersensitivity to study medications (local anesthetics, NSAIDs, opioids) * Chronic opioid use (longer than 4 weeks) * Use of psychiatric medications affecting pain perception * Inability to cooperate or communicate effectively * Requirement for postoperative intensive care

Locations (1)

Kartal Dr. Lütfi Kırdar City Hospital

Istanbul, Turkey (Türkiye)

Outcomes

Primary Outcomes

Total analgesic consumption in 24 hours

Total amount of dexketoprofen consumed in the first 24 hours after surgery

Time frame: 24 hours postoperative

Secondary Outcomes

Postoperative Pain Intensity (VAS Score)

Postoperative pain intensity assessed using the Visual Analog Scale (VAS, 0-10), where 0 indicates no pain and 10 indicates worst imaginable pain.

Time frame: 0 (15 minutes), 2, 4, 8, 12, 16, and 24 hours postoperative

Time to First Analgesic Requirement

Time from the end of surgery to the first request for analgesic medication

Time frame: Within 24 hours postoperative

Tramadol Consumption

Total amount of tramadol administered within the first 24 hours after surgery.

Time frame: 24 hours postoperative

Patient Satisfaction Score

Patient satisfaction assessed using a Likert scale evaluating overall satisfaction with postoperative pain management

Time frame: 24 hours postoperative

Incidence of Postoperative Nausea and Vomiting

Incidence of nausea and vomiting observed during the first 24 hours after surgery.

Time frame: 24 hours postoperative

Data from ClinicalTrials.gov

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