Modified Thoracoabdominal Nerves Block Through the Perichondrial Approach vs Subcostal Transversus Abdominis Plane Block for Postoperative Recovery After Laparoscopic Cholecystectomy: A Prospective, Randomized Clinical Trial
- Journal
- Medical science monitor : international medical journal of experimental and clinical research (Q2)
- Published
- 27 July 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Ahmet Kaciroglu, Eralp Cevikkalp, Mursel Ekinci, Mustafa Dikici, Ozkan Balcin, Merih Yildiz Eglen, et al.
- PMID
- 42503887
- DOI
- 10.12659/MSM.953976
Why clinicians should know about it
- Picked for Neurosurgery (paper of the day, 28 July 2026).
Abstract
BACKGROUND This study compared the effects of ultrasound-guided modified thoracoabdominal nerves block through the perichondrial approach (M-TAPA) and subcostal transversus abdominis plane (TAP) block on postoperative recovery after laparoscopic cholecystectomy. MATERIAL AND METHODS Sixty patients aged 18-65 years with American Society of Anesthesiologists physical status I-II undergoing elective laparoscopic cholecystectomy under general anesthesia were included. At the end of surgery, patients were randomly assigned to receive either ultrasound-guided subcostal TAP block (group T, n=30) or M-TAPA block (group M, n=30), with 20 mL of 0.25% bupivacaine administered on each side. Primary outcome was postoperative recovery at 24 hours (Quality of Recovery-15 [QoR-15] questionnaire). Secondary outcomes included postoperative pain scores (numerical rating scale [NRS]) at 0, 2, 4, 8, 16, and 24 hours, rescue analgesic requirements, and postoperative adverse effects. RESULTS The groups were comparable in age, height, weight, duration of surgery, and anesthesia-related variables (all P>0.05). Twenty-four-hour QoR-15 scores were similar between groups (P>0.05). Likewise, NRS pain scores did not differ significantly between groups (P>0.05). Significantly fewer patients required rescue analgesia in group M than in group T (30.0% vs 60.0%, P=0.020). Total rescue analgesic dose did not differ between groups (P=0.943). Postoperative adverse effects were comparable (P>0.05). CONCLUSIONS In patients undergoing laparoscopic cholecystectomy, ultrasound-guided M-TAPA block did not provide superior postoperative recovery, as assessed by QoR-15, compared with subcostal TAP block. Nevertheless, significantly fewer patients in the M-TAPA group required rescue analgesia (30.0% vs 60.0%, P=0.020), although total rescue analgesic consumption was similar between the groups.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.