About this trial
Laparoscopic cholecystectomy is a frequently performed surgical procedure and is considered the gold standard for treating symptomatic gallstone disease. Although laparoscopic cholecystectomy is considered minimally invasive, it can cause moderate to severe pain in the postoperative period. Poorly controlled early postoperative pain can impair recovery quality and increase the risk of postoperative pulmonary complications as a risk factor for chronic pain development. Multimodal analgesia, including opioids, is used to limit pain following laparoscopic cholecystectomy. However, opioid treatment may lead to side effects such as postoperative nausea and vomiting (PONV), respiratory depression, and constipation.
Nerve blocks provide better pain control, reduce opioid consumption in the postoperative period, and offer advantages such as fewer side effects and a lower risk of pulmonary and cardiac complications.
In our clinic, a multimodal analgesia approach is preferred for patients undergoing laparoscopic cholecystectomy. In addition to intravenous analgesic agents, peripheral nerve blocks are administered based on patient preference (for all eligible and consenting patients).
This study aims to compare the postoperative analgesic efficacy of the Transversus Abdominis Plane (TAP) Block and the Modified Thoracoabdominal Nerve Block with a Pericostal Approach (M-TAPA) in patients undergoing laparoscopic cholecystectomy. Standard analgesic methods are applied to patients who do not consent to peripheral nerve block administration.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
18 to 65 years old
American Society of Anesthesiologists (ASA) physical status I-II-III
Body mass index 18 to 30 kg/m2
Elective laparoscopic cholecystectomy surgery
Disqualifiers
Under 18 and over 65
ASA score IV and above
Advanced co-morbidity
History of bleeding diathesis
Trial design
Parallel
Treatments tested in this trial
Transversus Abdominis Plane (TAP) Block
DrugTransversus Abdominis Plane (TAP) Block is performed under ultrasound guidance before the surgical procedure and anesthesia induction, with the patient in the supine position.
Modified Thoracoabdominal Nerve Block (M-TAPA)
DrugModified Thoracoabdominal Nerve Block (M-TAPA) is performed under ultrasound guidance before the surgical procedure and anesthesia induction, with the patient in the supine position.
Treatment groups
Trial outcomes
Primary outcomes
Pain scores
Pain will be assessed at rest and while movement using the from 0 (no pain) to 10 (worst
Secondary outcomes
Intraoperative remifentanil consumption
The amount of remifentanil that patients need to maintain anesthesia during the intraoperative period will be recorded
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