Analgesic efficacy of modified thoracoabdominal nerves block through the perichondrial approach in laparoscopic cholecystectomy: A retrospective study with propensity analysis

Asian J Endosc Surg. 2023 Jul;16(3):648-652. doi: 10.1111/ases.13183. Epub 2023 Mar 23.

Abstract

Modified thoracoabdominal nerves block through the perichondral approach (M-TAPA) was recently reported to provide broad analgesia with only a single injection of local anesthetics (LA) on each side. However, the effectiveness of M-TAPA in laparoscopic cholecystectomy (LC) is not often reported. We retrospectively evaluated the analgesic efficacy of M-TAPA in patients who underwent LC and compared it with conventional LA infiltration (LAI) by calculating the propensity score. The primary outcome was the frequency of analgesic use after surgery. Although there was no difference in the frequency of analgesic use within 48 hours (P = .063), there was significantly less analgesic use 24-48 hours after surgery in the TAPA group (P = .02). Intraoperative remifentanil administration also significantly decreased in the TAPA group (P < .001). We found that pre-incisional M-TAPA may have an advantage over LAI with respect to analgesia on postoperative day 1.

Keywords: laparoscopic cholecystectomy; modified thoracoabdominal nerves block through the perichondral approach (M-TAPA); pre-emptive analgesia.

MeSH terms

  • Analgesics
  • Anesthetics, Local
  • Cholecystectomy, Laparoscopic* / methods
  • Humans
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / prevention & control
  • Retrospective Studies
  • Ultrasonography, Interventional

Substances

  • Anesthetics, Local
  • Analgesics