Comparison of the effects of M-TAPA or ESP block on postoperative analgesia in laparoscopic surgery

Objective: Reducing postoperative pain in laparoscopic cholecystectomy operations is still an important issue. In this thesis study, it was aimed to compare the postoperative VAS scores, the duration of the first additional analgesic requirement, patient satisfaction, and the length of hospital stay of M-TAPA or ESP block types in laparoscopic cholecystectomy operations within the scope of multimodal analgesia. Materials and Methods: Our study is a prospective clinical study and includes 40 patients aged between 18-70 years and with ASA scores between I-III who underwent elective laparoscopic cholecystectomy under general anesthesia between 01/09/2022 and 01/05/2023 at Afyonkarahisar Health Sciences University Hospital. The patients were divided into two groups according to the randomized sampling method as Group I (n=20) to which M-TAPA block was applied and Group II (n=20) to which ESP block was applied. All patients were examined approximately 30 min after the end of the operation. First, 1 mg/kg tramadol was administered intravenously for postoperative analgesia. Postoperative 24-hour dynamic and resting VAS scores, first additional analgesic hours, patient satisfaction, and hospital stay were evaluated. Results: While the second hour dynamic VAS scores were similar (p=0.067), the resting VAS score was found to be significantly lower in the M-TAPA group (p=0.018). The fourth and eighth hour resting and dynamic VAS scores were found to be statistically significantly lower in the M-TAPA group (p=0.002, p=0.003, p=0.024, p=0.045, respectively). The resting and dynamic VAS scores at the 12th and 24th hours were found to be similar between the groups. The time required for the first additional analgesic requirement was found to be statistically significantly longer in the M-TAPA group (p=0.041). Conclusion: It was observed that M-TAPA block reduced postoperative pain scores more than ESP block in laparoscopic cholecystectomy operations. In addition, since the first analgesia requirement is later in M-TAPA block, we believe that it is appropriate to prefer it for postoperative analgesia in cholecystectomy operations. Keywords: ESP block, laparoscopic surgery, M-TAPA, postoperative pain.