Comparision of M-TAPA Versus TAPB After Laparoscopic Cholecystectomy

Postoperative Analgesic Effect of Ultrasound-guided Thoracoabdominal Nerves Block Through Perichondrial Approach in Patients Undergoing Laparoscopic Cholecyctectomy: A Randomized Controlled Study

This randomized controlled study is designed to evaluate the postoperative analgesic effect of the ultrasound-guided modified thoracoabdominal nerves block through perichondrial approach (M-TAPA) in patients undergoing laparoscopic cholecystectomy. The investigators hypothesized that the US-guided M-TAPA would be more effective in postoperative pain control than the US-guided subcostal transversus abdominis plane block (TAPB).

Patients (Age>18 years) undergoing elective laparoscopic cholecystectomy are randomly allocated to receive bilateral US-guided M-TAPA (n=30) or bilateral subcostal TAPB (n=30) using 0.375% ropivacaine 15ml (total 30ml) before surgical incision. The blinded investigator evaluates each patient's parameters (Numeric rating scale, nausea, vomiting, pruritis, and patient satisfaction) at 1, 2, 4, 6, 12hours postoperatively, and immediately before discharge. The primary outcome is pain severity evaluated by a NRS at 12hours postoperatively.

Inclusion Criteria:

• Patients scheduled to undergo elective laparoscopic cholecystectomy
• American Society of Anesthesiologists (ASA) physical classification I-II

Exclusion Criteria:

• American Society of Anesthesiologists (ASA) physical classification III or more
• Chronic pain, chronic analgesic or antidepressant or anticonvulsant use
• Allergies to anesthetic or analgesic medications used in the protocol
• Single port laparoscopic cholecystectomy
• Patients with infection at the abdominal wall
• Medical or psychological disease that can affect the treatment response
• Do not understand our study