M-Tapa Block for Laparoscopic Inguinal Hernia Repair Surgery
Condition: Hernia, Inguinal
MeSH terms: Hernia; Hernia, Inguinal
Study type: Interventional

Summary: 
      Modified Perichondral Approach Thoracoabdominal Nerve (M-TAPA) block is a novel block that
      provides effective analgesia of the anterior and lateral thoracoabdominal walls during
      laparoscopic surgery, in which local anesthetic is applied only to the lower side of the
      perichondral surface. M-TAPA block is a good alternative for analgesia of the upper dermatome
      levels and the abdominal lateral wall, and may be an opioid-sparing strategy with
      satisfactory quality improvement in patients undergoing laparoscopic surgery.

      M-TAPA block provides analgesia at the level of T5-T11 in the abdominal region. Sonoanatomy
      is easy to visualize and the spread of local anesthetic can be easily seen. Analgesia occurs
      in several dermatomes thanks to the cephalocaudal spread of the local anesthetic solution.
      There are studies in the literature investigating the effectiveness of M-TAPA block for
      post-operative pain management in several abdominal surgeries.
    

Detailed description: 
      Modified Perichondral Approach Thoracoabdominal Nerve (M-TAPA) block is a novel block that
      provides effective analgesia of the anterior and lateral thoracoabdominal walls during
      laparoscopic surgery, in which local anesthetic is applied only to the lower side of the
      perichondral surface. M-TAPA block is a good alternative for analgesia of the upper dermatome
      levels and the abdominal lateral wall, and may be an opioid-sparing strategy with
      satisfactory quality improvement in patients undergoing laparoscopic surgery.

      M-TAPA block provides analgesia at the level of T5-T11 in the abdominal region. Sonoanatomy
      is easy to visualize and the spread of local anesthetic can be easily seen. Analgesia occurs
      in several dermatomes thanks to the cephalocaudal spread of the local anesthetic solution.
      There are studies in the literature investigating the effectiveness of M-TAPA block for
      post-operative pain management in several abdominal surgeries.

      In this study, we aimed to evaluate the effectiveness of M-TAPA block for postoperative
      analgesia management after laparoscopic inguinal hernia repair surgery. Our primary aim is to
      compare the postoperative pain scores (NRS), and our secondary aim is to compare the
      postoperative rescue analgesic use and postoperative opioid consumption, and the side effects
      (allergic reaction, nausea, vomiting) associated with opioid use.
    

Intervention name(s): M TAPA block
Intervention type(s): Drug
Intervention description(s): Under aseptic conditions, a high frequency linear probe will be placed on the costochondral angle in the sagittal plane. Then the probe will be slightly angled deeply to visualize the lower view of the perichondrium. We will perform M-TAPA with totally 40 ml (20 ml for each side) of %0,25 bupivacaine.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Sixty patients aged 18-65 years old with American Society of Anesthesiologists (ASA) classification I-II and scheduled for laparoscopic inguinal hernia repair surgery will be included in the study. Patients will be randomly divided into two groups (Group M = M-TAPA group, Group C = Control group) including 30 patients each, before entering the operating room.
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Laparoscopic inguinal hernia repair; Postoperative pain management; Modified Perichondral Approach Thoracoabdominal Nerve (M-TAPA) block