Plane Block, Regional Anaesthesia, Transversus Abdominis Plane (TAP) Block, Bariatric Surgery
Conditions
Keywords
perioperative pain management, M-TAPA block, peripheral plane block, pain management, bariatric surgery
Brief summary
Objective The aim of this study is to compare the analgesic efficacy of bilateral subcostal transversus abdominis plane (TAP) and modified thoracoabdominal (M-TAPA) blocks in reducing intraoperative opioid consumption and postoperative analgesic needs in patients undergoing laparoscopic sleeve gastrectomy (LSG). This will be a retrospective study conducted at Haseki Training and Research Hospital between January and November 2024. The study will include patients with a Body mass index (BMI) greater than 35 kg/m², aged between 18 and 65, who are scheduled to undergo LSG surgery. Patients will receive either a subcostal TAP or M-TAPA block before surgery. Data will be collected from patient records, including intraoperative opioid usage, postoperative analgesic consumption, and pain scores (NRS) assessed at rest and during activity in the first 24 hours. Secondary outcomes will include mobilization times and incidence of postoperative nausea and vomiting (PONV).
Detailed description
Objective The aim of this study is to compare the analgesic efficacy of bilateral subcostal transversus abdominis plane (TAP) and modified thoracoabdominal (M-TAPA) blocks in reducing intraoperative opioid consumption and postoperative analgesic needs in patients undergoing laparoscopic sleeve gastrectomy (LSG). Study Design This will be a retrospective study conducted at Haseki Training and Research Hospital between January and November 2024. The study will include patients with a BMI greater than 35 kg/m², aged between 18 and 65, who are scheduled to undergo LSG surgery. Patients will receive either a subcostal TAP or M-TAPA block before surgery. Data will be collected from patient records, including intraoperative opioid usage, postoperative analgesic consumption, and pain scores (NRS) assessed at rest and during activity in the first 24 hours. Secondary outcomes will include mobilization times and incidence of postoperative nausea and vomiting (PONV). Study Procedures Patients who meet the inclusion criteria will be included in the study, and data will be retrospectively reviewed. Intraoperative hemodynamic data, surgical duration, and total opioid consumption will be collected from anesthesia records. Postoperative analgesic use and pain scores will be assessed from nurse documentation and medical records. Patients with incomplete data or pre-existing chronic pain conditions will be excluded. Outcome Measures * Primary Outcome: Comparison of the analgesic efficacy of M-TAPA and subcostal TAP blocks during intraoperative and postoperative periods (first 24 hours). * Secondary Outcomes: Resting and active NRS pain scores, mobilization times, incidence of nausea and vomiting, and complications related to the block procedures.
Interventions
OTHERM-TAPA
this study will be compare the analgesic efficacy of bilateral subcostal transversus abdominis plane (TAP) and modified thoracoabdominal (M-TAPA) blocks in reducing intraoperative opioid consumption and postoperative analgesic needs in patients undergoing laparoscopic sleeve gastrectomy (LSG).
OTHERSubcostal TAP
this study will be compare the analgesic efficacy of bilateral subcostal transversus abdominis plane (TAP) and modified thoracoabdominal (M-TAPA) blocks in reducing intraoperative opioid consumption and postoperative analgesic needs in patients undergoing laparoscopic sleeve gastrectomy (LSG).
Sponsors
Haseki Training and Research Hospital
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* patients with a BMI greater than 35 kg/m², * aged between 18 and 65, who are scheduled to undergo LSG surgery. * Patients will receive either a subcostal TAP or M-TAPA block before surgery.
Exclusion criteria
* patients with incomplete data * patients with chronic pain * patients with preoperative opioid use * patients with preoperative alcohol/substance use
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Analgesic Efficacy | Intraoperative periods, postoperative first 24 hours. | Comparison of the analgesic efficacy of M-TAPA and subcostal TAP blocks during intraoperative and postoperative periods.The visual pain score includes values between 0 and 10. o means no pain, 5 means moderate pain, and 10 means severe pain. In the postoperative period, the pain levels of the patients will be compared by looking at this visual pain value. In the intraoperative period, the amount of analgesic consumption (total consumption of remifentanil mcg) will be evaluated. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Other conditions associated with the block | postoperative 24 hours | Resting and active NRS pain scores, mobilization times, nausea and vomiting frequency and complications related to block procedures. Visual pain scores of patients when they first start moving postoperatively will be examined. 0 is evaluated as no pain, 5 as moderate pain, 10 as very severe pain. The time they first started mobilizing will be determined according to the postoperative hour. It will be recorded as whether nausea and vomiting occurred or not. If there were other complications (e.g. bleeding at the block site, hematoma, shortness of breath, pneumothorax), all this information will be determined from the patient files. |
Countries
Turkey (Türkiye)
Outcome results
None listed