Anterior Quadratus lumborum block versus modified perichondrial thoracoabdominal nerve block (m-TAPA) for postoperative analgesia following laparoscopic cholecystectomy: a randomized controlled trial

Abstract Background Quadratus lumborum block (QLB) and modified thoracoabdominal nerves block through perichondrial approach (m-TAPA) can be used for postoperative analgesia in laparoscopic cholecystectomies (LC). The aim of this study is to evaluate the analgesic efficacy of anterior QLB and m-TAPA...

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Main Authors: Serpil Şehirlioğlu, Döndü Genç Moralar, Oguz Ozakin, Turan Aydemir, Fatma Ergul
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Anesthesiology
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Online Access:https://doi.org/10.1186/s12871-025-03281-x
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author Serpil Şehirlioğlu
Döndü Genç Moralar
Oguz Ozakin
Turan Aydemir
Fatma Ergul
author_facet Serpil Şehirlioğlu
Döndü Genç Moralar
Oguz Ozakin
Turan Aydemir
Fatma Ergul
author_sort Serpil Şehirlioğlu
collection DOAJ
description Abstract Background Quadratus lumborum block (QLB) and modified thoracoabdominal nerves block through perichondrial approach (m-TAPA) can be used for postoperative analgesia in laparoscopic cholecystectomies (LC). The aim of this study is to evaluate the analgesic efficacy of anterior QLB and m-TAPA during the first 24 hours postoperatively. Methods This study was designed as a randomized, prospective, single-blinded trial. Preoperatively, patients were divided into two groups: Group QLB (n=55) and Group m-TAPA (n=53). The anterior QLB was applied to Group QLB, while the m-TAPA was applied to the other group. After the blocks were administered, the dermatome areas covered at the 20th and 30th minutes were evaluated using a cold test. Intraoperative remifentanil consumption was recorded, while Numerical Rating Scale scores at rest (rNRS) and during movement (dNRS), opioid consumption, time to first rescue analgesic use, and complications were evaluated during the first 24 postoperative hours. Results There was no statistically significant difference between the groups in terms of total analgesic consumption during the first 24 hours, rNRS and dNRS values at hours 1, 4, 8, 12, and 24, time to first rescue analgesic use, intraoperative remifentanil consumption and complications. When comparing dermatome involvement between the groups, it was observed that dermatome coverage in the m-TAPA group was mostly distributed in the T7-T10 dermatomes, while in the QLB group, it was mostly distributed in the T10-L1 dermatomes. Conclusion We believe that both anterior QLB and m-TAPA can be used as part of opioid-free multimodal analgesia for postoperative analgesia during the first 24 hours in LC.
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spelling doaj-art-25df9f4728554a1fb9dddbd97b5c6fd82025-08-20T03:46:13ZengBMCBMC Anesthesiology1471-22532025-08-0125111110.1186/s12871-025-03281-xAnterior Quadratus lumborum block versus modified perichondrial thoracoabdominal nerve block (m-TAPA) for postoperative analgesia following laparoscopic cholecystectomy: a randomized controlled trialSerpil Şehirlioğlu0Döndü Genç Moralar1Oguz Ozakin2Turan Aydemir3Fatma Ergul4Department of Anesthesiology and Reanimation, Health Sciences University Gaziosmanpaşa Training and Research HospitalDepartment of Anesthesiology and Reanimation, Health Sciences University Gaziosmanpaşa Training and Research HospitalDepartment of Anesthesiology and Reanimation, Health Sciences University Gaziosmanpaşa Training and Research HospitalDepartment of Anesthesiology and Reanimation, Health Sciences University Gaziosmanpaşa Training and Research HospitalDepartment of Anesthesiology and Reanimation, Health Sciences University Gaziosmanpaşa Training and Research HospitalAbstract Background Quadratus lumborum block (QLB) and modified thoracoabdominal nerves block through perichondrial approach (m-TAPA) can be used for postoperative analgesia in laparoscopic cholecystectomies (LC). The aim of this study is to evaluate the analgesic efficacy of anterior QLB and m-TAPA during the first 24 hours postoperatively. Methods This study was designed as a randomized, prospective, single-blinded trial. Preoperatively, patients were divided into two groups: Group QLB (n=55) and Group m-TAPA (n=53). The anterior QLB was applied to Group QLB, while the m-TAPA was applied to the other group. After the blocks were administered, the dermatome areas covered at the 20th and 30th minutes were evaluated using a cold test. Intraoperative remifentanil consumption was recorded, while Numerical Rating Scale scores at rest (rNRS) and during movement (dNRS), opioid consumption, time to first rescue analgesic use, and complications were evaluated during the first 24 postoperative hours. Results There was no statistically significant difference between the groups in terms of total analgesic consumption during the first 24 hours, rNRS and dNRS values at hours 1, 4, 8, 12, and 24, time to first rescue analgesic use, intraoperative remifentanil consumption and complications. When comparing dermatome involvement between the groups, it was observed that dermatome coverage in the m-TAPA group was mostly distributed in the T7-T10 dermatomes, while in the QLB group, it was mostly distributed in the T10-L1 dermatomes. Conclusion We believe that both anterior QLB and m-TAPA can be used as part of opioid-free multimodal analgesia for postoperative analgesia during the first 24 hours in LC.https://doi.org/10.1186/s12871-025-03281-xPostoperative analgesiaNerve blockDermatomesQuadratus lumborum blockIntercostal nervesLaparoscopic cholecystectomy
spellingShingle Serpil Şehirlioğlu
Döndü Genç Moralar
Oguz Ozakin
Turan Aydemir
Fatma Ergul
Anterior Quadratus lumborum block versus modified perichondrial thoracoabdominal nerve block (m-TAPA) for postoperative analgesia following laparoscopic cholecystectomy: a randomized controlled trial
BMC Anesthesiology
Postoperative analgesia
Nerve block
Dermatomes
Quadratus lumborum block
Intercostal nerves
Laparoscopic cholecystectomy
title Anterior Quadratus lumborum block versus modified perichondrial thoracoabdominal nerve block (m-TAPA) for postoperative analgesia following laparoscopic cholecystectomy: a randomized controlled trial
title_full Anterior Quadratus lumborum block versus modified perichondrial thoracoabdominal nerve block (m-TAPA) for postoperative analgesia following laparoscopic cholecystectomy: a randomized controlled trial
title_fullStr Anterior Quadratus lumborum block versus modified perichondrial thoracoabdominal nerve block (m-TAPA) for postoperative analgesia following laparoscopic cholecystectomy: a randomized controlled trial
title_full_unstemmed Anterior Quadratus lumborum block versus modified perichondrial thoracoabdominal nerve block (m-TAPA) for postoperative analgesia following laparoscopic cholecystectomy: a randomized controlled trial
title_short Anterior Quadratus lumborum block versus modified perichondrial thoracoabdominal nerve block (m-TAPA) for postoperative analgesia following laparoscopic cholecystectomy: a randomized controlled trial
title_sort anterior quadratus lumborum block versus modified perichondrial thoracoabdominal nerve block m tapa for postoperative analgesia following laparoscopic cholecystectomy a randomized controlled trial
topic Postoperative analgesia
Nerve block
Dermatomes
Quadratus lumborum block
Intercostal nerves
Laparoscopic cholecystectomy
url https://doi.org/10.1186/s12871-025-03281-x
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