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

Effectiveness of Modified-Thoracoabdominal Nerve Block With Perichondrial Approach (M-TAPA) on Postoperative Pain Relief in Laparoscopic Hysterectomy Surgery: A Prospective, Randomized, Double-Blind, Controlled Study

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

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