Postoperative Analgesic Effectiveness of the Modified Thoracoabdominal Nerve Block Through a Perichondrial Approach in Total Laparoscopic Hysterectomy

NCT07740252 | Completed

• 1 other identifier: TNKU-MTAPA-TLH-001
• Study Type: observational
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

This single-center retrospective cohort study evaluated the effect of the modified thoracoabdominal nerves block through a perichondrial approach (M-TAPA) on postoperative analgesia in patients undergoing elective total laparoscopic hysterectomy. Medical records of 60 patients who underwent surgery at Tekirdag Namik Kemal University Faculty of Medicine Hospital between December 25, 2023 and December 25, 2024 were retrospectively reviewed. Patients who received bilateral ultrasound-guided M-TAPA block were compared with patients who received standard general anesthesia and systemic analgesia without M-TAPA block. The primary outcome was cumulative tramadol consumption during the first 24 postoperative hours. Secondary outcomes included postoperative Visual Analog Scale (VAS) pain scores at predefined time points, rescue analgesic requirements, postoperative nausea and vomiting, Quality of Recovery-15 (QoR-15) scores, and block-related complications.

Conditions

Hysterectomy; Postoperative Pain

Keywords

Modified thoracoabdominal nerves block through perichondrial approach; M-TAPA; Regional anesthesia; Postoperative analgesia

Outcome Measures

Primary Outcomes (1)

• Cumulative tramadol consumption during the first 24 postoperative hours

  Total tramadol consumption delivered by patient-controlled analgesia (PCA) during the first 24 postoperative hours.

  During the first 24 postoperative hours

Secondary Outcomes (5)

• Postoperative pain intensity

  At 0, 6, 12, and 24 hours after surgery

• Quality of recovery (QoR-15)

  At 24 hours after surgery

• Rescue analgesic requirements

  During the first 24 hours after surgery

• Postoperative nausea and vomiting

  During the first 24 hours after surgery

• Block-related complications

  During the first 24 postoperative hours

Study Arms (2)

M-TAPA Group

Patients who underwent elective total laparoscopic hysterectomy under general anesthesia and received bilateral ultrasound-guided modified thoracoabdominal nerves block through a perichondrial approach (M-TAPA) in addition to standard perioperative analgesia.

Procedure: Modified thoracoabdominal nerves block through a perichondrial approach (M-TAPA)

Control Group

Patients who underwent elective total laparoscopic hysterectomy under general anesthesia and received standard perioperative analgesia without modified thoracoabdominal nerves block through a perichondrial approach (M-TAPA).

Interventions

Modified thoracoabdominal nerves block through a perichondrial approach (M-TAPA) PROCEDURE

Bilateral ultrasound-guided modified thoracoabdominal nerves block through a perichondrial approach using 20 mL of 0.25% bupivacaine on each side (total volume: 40 mL), performed before surgical incision as part of multimodal analgesia.

M-TAPA Group

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Female patients aged 18-65 years with ASA physical status I-II who underwent elective total laparoscopic hysterectomy at Tekirdag Namik Kemal University Faculty of Medicine Hospital between December 25, 2023, and December 25, 2024.

You may qualify if:

• Female patients aged 18 to 65 years.
• American Society of Anesthesiologists (ASA) physical status I or II.
• Undergoing elective total laparoscopic hysterectomy under general anesthesia.
• Availability of complete perioperative and postoperative medical records.

You may not qualify if:

• Neurological disorders affecting pain perception.
• Coagulopathy or bleeding disorders.
• Known allergy to local anesthetics.
• Chronic opioid use before surgery.
• Body mass index (BMI) greater than 35 kg/m².
• Incomplete medical records.

Sponsors & Collaborators

• Namik Kemal University: lead

Study Sites (1)

Tekirdag Namik Kemal University Faculty of Medicine Hospital

Tekirdağ, Tekirdağ, 59030, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Pain, Postoperative

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor of Anesthesiology and Reanimation

Study Record Dates

• First Submitted: July 23, 2026
• First Posted: July 31, 2026
• Study Start: December 25, 2023
• Primary Completion: December 25, 2024
• Study Completion: December 25, 2024
• Last Updated: July 31, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)