M-TAPA vs OSTAP for Postoperative Analgesia in Laparoscopic Inguinal Hernia

Laparoscopic Inguinal Hernia Surgery Patients: Comparison of Modified Thoracoabdominal Nerve Block Through Perichondrial Approach (M-TAPA) and Oblique Subcostal TAP Block for Postoperative Analgesia

This randomized controlled trial aims to compare the postoperative analgesic efficacy of M-TAPA block and OSTAP block in patients undergoing laparoscopic inguinal hernia repair. Pain scores, analgesic consumption, and patient satisfaction will be evaluated.

Prospective, randomized, single-blind, controlled study including 90 patients undergoing elective laparoscopic inguinal hernia repair. Patients will be randomized into three groups: M-TAPA, OSTAP, and control. Postoperative pain scores (VAS), analgesic consumption, time to first analgesic requirement, and patient satisfaction will be assessed over 24 hours.

Inclusion Criteria:

• Patients aged between 18 and 65 years
• American Society of Anesthesiologists (ASA) physical status I-II
• Scheduled for elective laparoscopic inguinal hernia repair (TEP technique)
• Ability to understand and use the Visual Analog Scale (VAS)
• Provided written informed consent

Exclusion Criteria:

• Refusal to participate or inability to provide informed consent
• Age under 18 or over 65 years
• ASA physical status ≥ III
• Coagulopathy (including abnormal INR, thrombocytopenia, or platelet dysfunction)
• Infection at the injection site
• Known allergy or hypersensitivity to study medications (local anesthetics, NSAIDs, opioids)
• Chronic opioid use (longer than 4 weeks)
• Use of psychiatric medications affecting pain perception
• Inability to cooperate or communicate effectively
• Requirement for postoperative intensive care