The goal of this study is to compare the analgesic efficacy of M-TAPA block and TAP block in patients undergoing laparoscopic appendectomy surgeries
Adult patients older than 18 years of age who will undergo laparoscopic appendectomy under general anesthesia and will be American Society of Anesthesiologists (ASA) I-II-III according to the ASA risk classification.
Patients who did not give consent,
patients with coagulopathy,
patients with signs of infection at the block application site,
patients using anticoagulants,
Parallel
M-TAPA block with bupivacaine 25%
Other interventionFollowing sterile conditions for bilateral M-TAPA block application, the transducer will be inserted on the chondrium in the sagittal plane at the 9-10th rib level. Subsequently, a deep angle will be created with the probe for visualization of the underside of the costochondrium. The sonovisible needle tip will be placed just below the chondrium and saline (5 ml) will be injected for site confirmation. After the confirmation, 20 ml of 0.25% bupivacaine will be administered for each group for a total of 40 ml of local anesthetic. Blocks will be applied using an 80 mm sonovisible needle with a 6-10 MHz linear probe under the guidance of a portable ultrasound. M-TAPA block with the same standard technique and drug dose will be applied to the contralateral side for each group of M-TAPA patients.
TAP block with bupivacaine 25%
Other interventionAfter the necessary sterilization conditions established, the linear ultrasound probe will be placed in the middle of the iliac crest with the end limit of the ribs. Starting with skin, the layers in descending order, subcutaneous adipose tissue, external oblique muscle, internal oblique muscle, transversus abdominis muscle, and peritoneum will be identified. As the tip of the 80 mm sonovisible needle passes through the muscular layers and fascia, the needle will be advanced in a controlled manner. After receiving the click sensation (passage of the fascia of the internal oblique muscle), the location of the needle will be fixed and 20 ml of 0.25% bupivacaine will be injected between internal oblique and transversus abdominis muscles. Same procedure will be performed to the other site. (40 ml local anesthetics in total)
Comparing the numerical rating scale scores
Numerical rating scale will be used for pain assessment. The scores of the numerical rating scale changes between 0 to 10 points. 10 points mean "the most severe pain that the patient ever had". 0 point means "there is no pain." Higher scores mean worse outcome.
Comparing total tramadol consumption
Postoperative analgesic need
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