Clinical Research Directory

Comparison of M-TAPA, EOIP, and Local Infiltration for Pain Relief After Laparoscopic Cholecystectomy

This retrospective observational study aimed to compare three pain management techniques used after laparoscopic gallbladder removal (cholecystectomy): modified thoracoabdominal nerve block through the perichondrial approach (M-TAPA), external oblique intercostal plane (EOIP) block, and local anesthetic infiltration. The study included 90 adult patients who underwent elective laparoscopic cholecystectomy between January and April 2025. Patients were divided into three groups according to the pain management technique they received during routine clinical care, with 30 patients in each group. The primary outcome was pain intensity measured 2 hours after surgery using a visual analog scale (VAS). Additional outcomes included pain scores at 15 minutes and 4, 8, 16, and 24 hours after surgery, the need for additional opioid pain medication, and opioid-related adverse events. The study aimed to evaluate differences in postoperative pain control and the need for additional pain medication among these three techniques using previously collected medical records.

Bilateral Modified Thoracoabdominal Nerve Block as an Analgesic Technique in Comparison With Bilateral Thoracic Erector Spinae Plane Block in Abdominoplasty Operations

This study aimed to compare the analgesic effect of bilateral ultrasound-guided modified thoracoabdominal nerve block with bilateral ultrasound-guided erector spinae plane block in abdominoplasty surgery.

Comparison of Postoperative Analgesic Efficacy of Transversus Abdominis Plane Block (TAP) and Modified Thoracoabdominal Nerve Block (M-TAPA)

Laparoscopic cholecystectomy is a frequently performed surgical procedure and is considered the gold standard for treating symptomatic gallstone disease. Although laparoscopic cholecystectomy is considered minimally invasive, it can cause moderate to severe pain in the postoperative period. Poorly controlled early postoperative pain can impair recovery quality and increase the risk of postoperative pulmonary complications as a risk factor for chronic pain development. Multimodal analgesia, including opioids, is used to limit pain following laparoscopic cholecystectomy. However, opioid treatment may lead to side effects such as postoperative nausea and vomiting (PONV), respiratory depression, and constipation. Nerve blocks provide better pain control, reduce opioid consumption in the postoperative period, and offer advantages such as fewer side effects and a lower risk of pulmonary and cardiac complications. In our clinic, a multimodal analgesia approach is preferred for patients undergoing laparoscopic cholecystectomy. In addition to intravenous analgesic agents, peripheral nerve blocks are administered based on patient preference (for all eligible and consenting patients). This study aims to compare the postoperative analgesic efficacy of the Transversus Abdominis Plane (TAP) Block and the Modified Thoracoabdominal Nerve Block with a Pericostal Approach (M-TAPA) in patients undergoing laparoscopic cholecystectomy. Standard analgesic methods are applied to patients who do not consent to peripheral nerve block administration.