Modified thoracoabdominal nerve block via perichondral approach: an alternative for perioperative pain management in laparoscopic cholecystectomy in a middle-income country

• Published in: BMC anesthesiology 2024-08, Vol.24 (1), p.304-8, Article 304
• Main Authors: Castillo-Dávila, Luisa Fernanda, Torres-Anaya, Carlos Jesús, Vazquez-Apodaca, Raquel, Borboa-Olivares, Hector, Espino-Y-Sosa, Salvador, Torres-Torres, Johnatan
• Format: Article
• Language: English
• Subjects: Abdomen; Adult; Analgesia; Analgesics; Analgesics, Opioid - administration & dosage; Analgesics, Opioid - therapeutic use; Anesthesia; Anesthetics; Blood pressure; Care and treatment; Cartilage; Case-Control Studies; Cholecystectomy; Cholecystectomy, Laparoscopic - methods; Dexmedetomidine; Female; Fentanyl; Heart rate; Humans; Laparoscopic cholecystectomy; Laparoscopic surgery; Laparoscopy; Male; Medical research; Medicine, Experimental; Methods; Mexico; Middle Aged; Modified thoracoabdominal nerve block (M-TAPA); Narcotics; Nerve Block - methods; Opioid consumption; Opioids; Pain; Pain management; Pain Management - methods; Pain perception; Pain, Postoperative - drug therapy; Patients; Perioperative pain management; Postoperative analgesia; Recovery (Medical); Retrospective Studies; Surgery; Survival analysis; Ultrasonic imaging; Variance analysis
• ISSN: 1471-2253; 1471-2253
• DOI: 10.1186/s12871-024-02690-8

Laparoscopic cholecystectomy is known for its minimally invasive nature, but postoperative pain management remains challenging. Despite the enhanced recovery after surgery (ERAS) protocol, regional analgesic techniques like modified perichondral approach to thoracoabdominal nerve block (M-TAPA) show promise. Our retrospective study evaluates M-TAPA's efficacy in postoperative pain control for laparoscopic cholecystectomy in a middle-income country. This was a retrospective case-control study of laparoscopic cholecystectomy patients at Hospital General de Mexico in which patients were allocated to the M-TAPA or control group. The data included demographic information, intraoperative variables, and postoperative pain scores. M-TAPA blocks were administered presurgery. opioid consumption, pain intensity, adverse effects, and time to rescue analgesia. Analysis of variance (ANOVA) compared total opioid consumption between groups, while Student's t test compared pain intensity and time until the first request for rescue analgesia. Among the 56 patients, those in the M-TAPA group had longer surgical and anesthetic times (p