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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
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| M-TAPA Group | Experimental |
| |
| Control Group | No Intervention |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Modified-Thoracoabdominal Nerve Block through a Perichondrial Approach (M-TAPA) | Procedure | Under ultrasound guidance, a 22-gauge peripheral block needle is inserted at the costochondral angle (9th-10th ribs). After confirming the position, 20 ml of 0.25% bupivacaine is injected bilaterally into the lower part of the chondrium. |
| Measure | Description | Time Frame |
|---|---|---|
| Morphine consumption | Total amount of morphine (mg) used via Patient-Controlled Analgesia (PCA) | First 24 hours postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative Pain Scores (NRS) | Numerical Rating Scale (0=no pain, 10=worst pain) | Baseline (Hour 0), 1, 2, 4, 6, 12, and 24 hours postoperatively |
| Rescue analgesic drug consumption | The amount of rescue analgesic in mg required by the patient will be recorded for the first 24 hours. |
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Inclusion Criteria:
Exclusion Criteria:
Only female participants are eligible for this study, as the research focuses on postoperative pain management following laparoscopic hysterectomy (surgical removal of the uterus). All participants are individuals scheduled for elective laparoscopic hysterectomy surgery under general anesthesia.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| onur senyurt | Contact | +905520265992 | senyurtonur@yahoo.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Istinye University Liv Hospital Bahcesehir | Recruiting | Istanbul | Turkey (Türkiye) |
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|
| Within the first 24 hours postoperatively |
| Incidence of postoperative nausea and vomiting | Number of patients developing postoperative nausea and vomiting will be recorded for the first 24 hours | Within the first 24 hours postoperatively |
| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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