Regional Anesthesia Morbidity
Conditions
Brief summary
Laparoscopic cholecystectomy is a common abdominal surgery in Western countries, favored for its minimal invasiveness, leading to less pain, smaller scars, and quicker recovery. Despite its benefits, it is contraindicated in cases of bleeding disorders, peritonitis, hemodynamic instability, severe heart failure, and advanced COPD. Effective postoperative pain management is crucial for faster recovery, shorter hospital stays, and lower costs, using techniques such as intravenous or intramuscular analgesics, epidural analgesia, and local anesthetic injections like TAP block or M-TAPA block. The TAPA block, introduced in 2019, involves applying local anesthetic to the costochondral junction, affecting thoracoabdominal nerves, with a modified version (M- TAPA) applying anesthetic to the lower surface only. Studies have shown M-TAPA's efficacy in reducing pain and analgesic use postoperatively. Postoperative pain from laparoscopic cholecystectomy mainly arises from inflammation in the gallbladder bed and pneumoperitoneum. This study aims to evaluate the postoperative analgesic efficacy of intraperitoneal bupivacaine, bupivacaine with dexmedetomidine, and M-TAPA block by assessing pain scores and analgesic consumption in a prospective, randomized, double- blind trial with 45 patients. Patients will be assigned to three groups: M- TAPA block, intraperitoneal bupivacaine, and intraperitoneal bupivacaine with dexmedetomidine, with an experienced anesthetist administering the blocks and evaluating outcomes to compare these pain management techniques.
Interventions
PROCEDUREapplication for postoperative analgesia
three different methods will be applied to reduce patients' postoperative pain
Sponsors
Sivas State Hospital
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Caregiver, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Laparoscopic cholecystectomy surgery planned * ASA #-II-III classification * Willingness to participate in the study
Exclusion criteria
* Bleeding disorders * Signs of infection at the block application site * Conversion to open surgery * Allergy to local anesthetics * Unstable hemodynamics * Inability to provide informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| pain scores | Time Frame: 24 hours after the procedure | zero meaning no pain and 10 meaning the worst pain imaginable |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| total analgesic consumption | 24 hours after the procedure | total rescue analgesic consumption of patients will be evaluated |
Countries
Turkey (Türkiye)
Outcome results
None listed