Hysterectomy, Plane Blocks, Postoperative Pain
Conditions
Brief summary
This study aims to investigate the effectiveness of a specific regional anesthesia technique, the Modified-Thoracoabdominal Nerve Block through a Perichondrial Approach (M-TAPA), on reducing pain after laparoscopic hysterectomy surgery. Hysterectomy is a common major surgical procedure, and managing postoperative pain is crucial for patient comfort and faster recovery. Participants will be randomly assigned to one of two groups: The M-TAPA Group: Patients will receive the nerve block using a local anesthetic (bupivacaine) before the surgery begins. The Control Group: Patients will receive standard postoperative pain management without the nerve block. The primary goal is to determine if the M-TAPA block reduces the total amount of opioid (morphine) used by patients in the first 24 hours after surgery. The researchers will also evaluate pain scores (NRS), the time until the first request for additional pain medication, patient satisfaction, and any side effects like nausea or vomiting
Interventions
PROCEDUREModified-Thoracoabdominal Nerve Block through a Perichondrial Approach (M-TAPA)
Under ultrasound guidance, a 22-gauge peripheral block needle is inserted at the costochondral angle (9th-10th ribs). After confirming the position, 20 ml of 0.25% bupivacaine is injected bilaterally into the lower part of the chondrium.
Sponsors
Istinye University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Aged between 18 and 70 years * ASA (American Society of Anesthesiologists) physical status I, II, or III * Scheduled for elective laparoscopic hysterectomy * Voluntary participation with signed informed consent
Exclusion criteria
* Hepatic or renal disease. * Coagulation disorders. * Uncontrolled cardiovascular or respiratory diseases. * Psychiatric disorders. * History of allergy to local anesthetics. * History of alcoholism, drug or substance abuse. * Body Mass Index (BMI) greater than 35 kg/m2 * Refusal of the regional block procedure
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Morphine consumption | First 24 hours postoperatively | Total amount of morphine (mg) used via Patient-Controlled Analgesia (PCA) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Pain Scores (NRS) | Baseline (Hour 0), 1, 2, 4, 6, 12, and 24 hours postoperatively | Numerical Rating Scale (0=no pain, 10=worst pain) |
| Rescue analgesic drug consumption | Within the first 24 hours postoperatively | The amount of rescue analgesic in mg required by the patient will be recorded for the first 24 hours. |
| Incidence of postoperative nausea and vomiting | Within the first 24 hours postoperatively | Number of patients developing postoperative nausea and vomiting will be recorded for the first 24 hours |
Countries
Turkey (Türkiye)
Contacts
CONTACTonur senyurt
Outcome results
None listed