Skip to main content
Erschienen in:

11.09.2024 | Original Contributions

Bilateral Ultrasound-Guided External Oblique Intercostal Block Vs. Modified Thoracoabdominal Nerve Block Through Perichondrial Approach for Postoperative Analgesia in Patients Undergoing Laparoscopic Sleeve Gastrectomy Surgery: A Randomized Controlled Study

verfasst von: Esra Turunc, Burhan Dost, Elif Sarikaya Ozel, Cengiz Kaya, Yasemin B. Ustun, Sezgin Bilgin, Gokhan S. Ozbalci, Ersin Koksal

Erschienen in: Obesity Surgery | Ausgabe 10/2024

Einloggen, um Zugang zu erhalten

Abstract

Introduction

The objective of the present study was to evaluate morphine consumption and pain scores 24 h postoperatively to compare the effects of a bilateral External Oblique Intercostal (EOI) block with those of a Modified Thoracoabdominal Nerve Block Trough Perichondrial Approach (M-TAPA) block in laparoscopic sleeve gastrectomy (LSG).

Methods

Fifty-eight patients aged between 18 and 65 years of with American Society of Anesthesiologists class II–III were included in this randomized, double-blinded study. Patients were assigned into two groups either EOI block or M-TAPA block. The primary outcome was cumulative morphine consumption within the first postoperative 24 h. Secondary outcomes were numerical rating scale (NRS) scores at rest and during activity, QoR-15 Patient Questionnaire scores, incidence of postoperative nausea and vomiting (PONV), number of patients requiring rescue analgesic and antiemetics drugs, and complications.

Results

There was no statistically significant difference between the groups in terms of morphine consumption in the first 24 h (EOI block; 10.74 ± 3.94 mg vs. M-TAPA block; 11.67 ± 4.66 mg, respectively). In addition, no significant difference between the two groups in the NRS and PONV scores, total QoR-15 scores, and the number of patients requiring rescue analgesics and antiemetics.

Conclusions

EOI block and M-TAPA block showed similar effectiveness for morphine consumption within 24 h postoperatively and in pain scores in LSG.

Graphical Abstract

Literatur
1.
Zurück zum Zitat Finkelstein EA, Khavjou OA, Thompson H, et al. Obesity and severe obesity forecasts through 2030. Am J Prev Med. 2012;42(6):563–70.CrossRefPubMed Finkelstein EA, Khavjou OA, Thompson H, et al. Obesity and severe obesity forecasts through 2030. Am J Prev Med. 2012;42(6):563–70.CrossRefPubMed
2.
Zurück zum Zitat Hartwig M, Allvin R, Bäckström R, et al. Factors associated with increased experience of postoperative pain after laparoscopic gastric bypass surgery. Obes Surg. 2017;27(7):1854–8.CrossRefPubMedPubMedCentral Hartwig M, Allvin R, Bäckström R, et al. Factors associated with increased experience of postoperative pain after laparoscopic gastric bypass surgery. Obes Surg. 2017;27(7):1854–8.CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Földi M, Soós A, Hegyi P, et al. Transversus abdominis plane block appears to be effective and safe as a part of multimodal analgesia in bariatric surgery: a meta-analysis and systematic review of randomized controlled trials. Obes Surg. 2021;31(2):531–43.CrossRefPubMed Földi M, Soós A, Hegyi P, et al. Transversus abdominis plane block appears to be effective and safe as a part of multimodal analgesia in bariatric surgery: a meta-analysis and systematic review of randomized controlled trials. Obes Surg. 2021;31(2):531–43.CrossRefPubMed
4.
Zurück zum Zitat Elsharkawy H, Maniker R, Bolash R, et al. Rhomboid intercostal and subserratus plane block: a cadaveric and clinical evaluation. Reg Anesth Pain Med. 2018;43(7):745–51.PubMed Elsharkawy H, Maniker R, Bolash R, et al. Rhomboid intercostal and subserratus plane block: a cadaveric and clinical evaluation. Reg Anesth Pain Med. 2018;43(7):745–51.PubMed
5.
Zurück zum Zitat White L, Ji A. External oblique intercostal plane block for upper abdominal surgery: use in obese patients. Br J Anaesth. 2022;128(5):e295–7.CrossRefPubMed White L, Ji A. External oblique intercostal plane block for upper abdominal surgery: use in obese patients. Br J Anaesth. 2022;128(5):e295–7.CrossRefPubMed
6.
Zurück zum Zitat Bilge A, Başaran B, Et T, et al. Ultrasound-guided bilateral modified-thoracoabdominal nerve block through a perichondrial approach (M-TAPA) in patients undergoing laparoscopic cholecystectomy: a randomized double-blind controlled trial. BMC Anesthesiol. 2022;22(1):329.CrossRefPubMedPubMedCentral Bilge A, Başaran B, Et T, et al. Ultrasound-guided bilateral modified-thoracoabdominal nerve block through a perichondrial approach (M-TAPA) in patients undergoing laparoscopic cholecystectomy: a randomized double-blind controlled trial. BMC Anesthesiol. 2022;22(1):329.CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Selvi O, Azizoğlu M, Temel G, et al. Translation and validation of the turkish version of the quality of postoperative recovery score QoR-15: a multi-centred cohort study. Turk J Anaesthesiol Reanim. 2022;50(6):443–8.CrossRefPubMedPubMedCentral Selvi O, Azizoğlu M, Temel G, et al. Translation and validation of the turkish version of the quality of postoperative recovery score QoR-15: a multi-centred cohort study. Turk J Anaesthesiol Reanim. 2022;50(6):443–8.CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Ohgoshi Y, Kawagoe I, Ando A, et al. Novel external oblique muscle plane block for blockade of the lateral abdominal wall: a pilot study on volunteers. Can J Anaesth. 2022;69(10):1203–10.CrossRefPubMed Ohgoshi Y, Kawagoe I, Ando A, et al. Novel external oblique muscle plane block for blockade of the lateral abdominal wall: a pilot study on volunteers. Can J Anaesth. 2022;69(10):1203–10.CrossRefPubMed
9.
Zurück zum Zitat Grape S, Kirkham KR, Albrecht E. The analgesic efficacy of transversus abdominis plane block after bariatric surgery: a systematic review and meta-analysis with trial sequential analysis. Obes Surg. 2020;30(10):4061–70.CrossRefPubMed Grape S, Kirkham KR, Albrecht E. The analgesic efficacy of transversus abdominis plane block after bariatric surgery: a systematic review and meta-analysis with trial sequential analysis. Obes Surg. 2020;30(10):4061–70.CrossRefPubMed
10.
Zurück zum Zitat De Cassai A, Paganini G, Pettenuzzo T, et al. Single-shot regional anesthesia for bariatric surgery: a systematic review and network meta-analysis. Obes Surg. 2023;33(9):2687–94.CrossRefPubMed De Cassai A, Paganini G, Pettenuzzo T, et al. Single-shot regional anesthesia for bariatric surgery: a systematic review and network meta-analysis. Obes Surg. 2023;33(9):2687–94.CrossRefPubMed
11.
Zurück zum Zitat Elshazly M, El-Halafawy YM, Mohamed DZ, et al. Feasibility and efficacy of erector spinae plane block versus transversus abdominis plane block in laparoscopic bariatric surgery: a randomized comparative trial. Korean J Anesthesiol. 2022;75(6):502–9.PubMedPubMedCentral Elshazly M, El-Halafawy YM, Mohamed DZ, et al. Feasibility and efficacy of erector spinae plane block versus transversus abdominis plane block in laparoscopic bariatric surgery: a randomized comparative trial. Korean J Anesthesiol. 2022;75(6):502–9.PubMedPubMedCentral
12.
Zurück zum Zitat Elsharkawy H, Kolli S, Soliman LM, et al. The external oblique intercostal block: anatomic evaluation and case series. Pain Med. 2021;22(11):2436–42.CrossRefPubMed Elsharkawy H, Kolli S, Soliman LM, et al. The external oblique intercostal block: anatomic evaluation and case series. Pain Med. 2021;22(11):2436–42.CrossRefPubMed
13.
Zurück zum Zitat Hamilton DL, Manickam BP, Wilson MAJ, et al. External oblique fascial plane block. Reg Anesth Pain Med. 2019;44(4):528–9.CrossRef Hamilton DL, Manickam BP, Wilson MAJ, et al. External oblique fascial plane block. Reg Anesth Pain Med. 2019;44(4):528–9.CrossRef
14.
Zurück zum Zitat Kavakli AS, Sahin T, Koc U, et al. Ultrasound-guided external oblique intercostal plane block for postoperative analgesia in laparoscopic sleeve gastrectomy: a prospective, randomized, controlled, patient and observer-blinded study. Obes Surg. 2024;34:1505.CrossRefPubMedPubMedCentral Kavakli AS, Sahin T, Koc U, et al. Ultrasound-guided external oblique intercostal plane block for postoperative analgesia in laparoscopic sleeve gastrectomy: a prospective, randomized, controlled, patient and observer-blinded study. Obes Surg. 2024;34:1505.CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Doymus O, Ahiskalioglu A, Kaciroglu A, et al. External oblique intercostal plane block versus port-site infiltration for laparoscopic sleeve gastrectomy: a randomized controlled study. Obes Surg. 2024;34:1826.CrossRefPubMedPubMedCentral Doymus O, Ahiskalioglu A, Kaciroglu A, et al. External oblique intercostal plane block versus port-site infiltration for laparoscopic sleeve gastrectomy: a randomized controlled study. Obes Surg. 2024;34:1826.CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Korkusuz M, Basaran B, Et T, et al. Bilateral external oblique intercostal plane block (EOIPB) in patients undergoing laparoscopic cholecystectomy: a randomized controlled trial. Saudi Med J. 2023;44(10):1037–46.CrossRefPubMedPubMedCentral Korkusuz M, Basaran B, Et T, et al. Bilateral external oblique intercostal plane block (EOIPB) in patients undergoing laparoscopic cholecystectomy: a randomized controlled trial. Saudi Med J. 2023;44(10):1037–46.CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Coşarcan SK, Yavuz Y, Doğan AT, et al. Can postoperative pain be prevented in bariatric surgery? efficacy and usability of fascial plane blocks: a retrospective clinical study. Obes Surg. 2022;32(9):2921–9.CrossRefPubMed Coşarcan SK, Yavuz Y, Doğan AT, et al. Can postoperative pain be prevented in bariatric surgery? efficacy and usability of fascial plane blocks: a retrospective clinical study. Obes Surg. 2022;32(9):2921–9.CrossRefPubMed
18.
Zurück zum Zitat Tulgar S, Selvi O, Thomas DT, et al. Modified thoracoabdominal nerves block through perichondrial approach (M-TAPA) provides effective analgesia in abdominal surgery and is a choice for opioid sparing anesthesia. J Clin Anesth. 2019;55:109.CrossRefPubMed Tulgar S, Selvi O, Thomas DT, et al. Modified thoracoabdominal nerves block through perichondrial approach (M-TAPA) provides effective analgesia in abdominal surgery and is a choice for opioid sparing anesthesia. J Clin Anesth. 2019;55:109.CrossRefPubMed
19.
Zurück zum Zitat Altıparmak B, Korkmaz Toker M, Uysal Aİ, et al. The successful usage of modified thoracoabdominal nerves block through perichondrial approach (M-TAPA) for analgesia of laparoscopic ventral hernia repair. J Clin Anesth. 2019;57:1–2.CrossRefPubMed Altıparmak B, Korkmaz Toker M, Uysal Aİ, et al. The successful usage of modified thoracoabdominal nerves block through perichondrial approach (M-TAPA) for analgesia of laparoscopic ventral hernia repair. J Clin Anesth. 2019;57:1–2.CrossRefPubMed
20.
Zurück zum Zitat Güngör H, Ciftci B, Alver S, et al. Modified thoracoabdominal nerve block through perichondrial approach (M-TAPA) vs local infiltration for pain management after laparoscopic cholecystectomy surgery: a randomized study. J Anesth. 2023;37(2):254–60.CrossRefPubMed Güngör H, Ciftci B, Alver S, et al. Modified thoracoabdominal nerve block through perichondrial approach (M-TAPA) vs local infiltration for pain management after laparoscopic cholecystectomy surgery: a randomized study. J Anesth. 2023;37(2):254–60.CrossRefPubMed
21.
Zurück zum Zitat Alver S, Ciftci B, Güngör H, et al. Efficacy of modified thoracoabdominal nerve block through perichondrial approach following laparoscopic inguinal hernia repair surgery: a randomized controlled trial. Braz J Anesthesiol. 2023;73(5):595–602.PubMedPubMedCentral Alver S, Ciftci B, Güngör H, et al. Efficacy of modified thoracoabdominal nerve block through perichondrial approach following laparoscopic inguinal hernia repair surgery: a randomized controlled trial. Braz J Anesthesiol. 2023;73(5):595–602.PubMedPubMedCentral
22.
Zurück zum Zitat Ciftci B, Alici HA, Ansen G, et al. Cadaveric investigation of the spread of the thoracoabdominal nerve block using the perichondral and modified perichondral approaches. Korean J Anesthesiol. 2022;75(4):357–9.CrossRefPubMedPubMedCentral Ciftci B, Alici HA, Ansen G, et al. Cadaveric investigation of the spread of the thoracoabdominal nerve block using the perichondral and modified perichondral approaches. Korean J Anesthesiol. 2022;75(4):357–9.CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Sawada A, Kumita S, Nitta A, Ohsaki Y, Yamakage M. Modified thoracoabdominal nerve block through perichondrial approach (M-TAPA): an anatomical study to evaluate the spread of dye after a simulated injection in soft embalmed Thiel cadavers. Reg Anesth Pain Med. 2023;48(8):403–7.CrossRefPubMed Sawada A, Kumita S, Nitta A, Ohsaki Y, Yamakage M. Modified thoracoabdominal nerve block through perichondrial approach (M-TAPA): an anatomical study to evaluate the spread of dye after a simulated injection in soft embalmed Thiel cadavers. Reg Anesth Pain Med. 2023;48(8):403–7.CrossRefPubMed
24.
Zurück zum Zitat Hill J, Ashken T, West S, et al. Core outcome set for peripheral regional anesthesia research: a systematic review and Delphi study. Reg Anesth Pain Med. 2022;47(11):691–7.CrossRef Hill J, Ashken T, West S, et al. Core outcome set for peripheral regional anesthesia research: a systematic review and Delphi study. Reg Anesth Pain Med. 2022;47(11):691–7.CrossRef
Metadaten
Titel
Bilateral Ultrasound-Guided External Oblique Intercostal Block Vs. Modified Thoracoabdominal Nerve Block Through Perichondrial Approach for Postoperative Analgesia in Patients Undergoing Laparoscopic Sleeve Gastrectomy Surgery: A Randomized Controlled Study
verfasst von
Esra Turunc
Burhan Dost
Elif Sarikaya Ozel
Cengiz Kaya
Yasemin B. Ustun
Sezgin Bilgin
Gokhan S. Ozbalci
Ersin Koksal
Publikationsdatum
11.09.2024
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 10/2024
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-024-07454-4

Neu im Fachgebiet Chirurgie

Verbände und Cremes gegen Dekubitus: „Wir wissen nicht, was sie bringen!“

Die Datenlage zur Wirksamkeit von Verbänden oder topischen Mitteln zur Prävention von Druckgeschwüren sei schlecht, so die Verfasser einer aktuellen Cochrane-Studie. Letztlich bleibe es unsicher, ob solche Maßnahmen den Betroffenen nutzen oder schaden.

Nackenschmerzen nach Bandscheibenvorfall: Muskeltraining hilft!

Bei hartnäckigen Schmerzen aufgrund einer zervikalen Radikulopathie schlägt ein Team der Universität Istanbul vor, lokale Steroidinjektionen mit einem speziellen Trainingsprogramm zur Stabilisierung der Nackenmuskulatur zu kombinieren.

US-Team empfiehlt Gastropexie nach Hiatushernien-Op.

Zur Vermeidung von Rezidiven nach Reparatur einer paraösophagealen Hiatushernie sollte einem US-Team zufolge der Magen bei der Op. routinemäßig an der Bauchwand fixiert werden. Das Ergebnis einer randomisierten Studie scheint dafür zu sprechen.

Mit Lidocain kommt der Darm nicht schneller in Schwung

Verzögertes Wiederanspringen der Darmfunktion ist ein Hauptfaktor dafür, wenn Patientinnen und Patienten nach einer Kolonresektion länger als geplant im Krankenhaus bleiben müssen. Ob man diesem Problem mit Lidocain vorbeugen kann, war Thema einer Studie.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.