Effects of M-TAPA Block on Pulmonary Functions

Study Overview
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Brief Summary
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Adequate postoperative analgesia is difficult to achieve in patients undergoing laparoscopic sleeve gastrectomy (LSG). Epidural anesthesia is technically difficult due to subcutaneous fat, which increases the risk of serious complications. Moreover, patients in this condition often have comorbidities that require anticoagulation therapy. Although ultrasound-guided Transversus Abdominis Plane (TAP) block may be useful, it is still controversial. Recently, modified thoracoabdominal nerve block via perichondrial approach (M-TAPA) has been reported as a new and promising technique that provides effective analgesia in the anterior and lateral thoracoabdominal wall. The most common reason for hospitalization after laparoscopic surgery is pain after nausea and vomiting. In addition, superficial and tachypneic breathing resulting from the patient's inability to breathe deeply with pain causes closure of small airways and increase in intrapulmonary shunts, resulting in hypoxia. Postoperative pain management is important not only to prevent pain but also to reduce pulmonary complications that may occur due to changes in lung function and to reduce mortality and morbidity by controlling the stress response. In this study, we investigated the effect of modified thoracoabdominal nerve block via perichondrial approach (M-TAPA) on pulmonary function in patients undergoing laparoscopic bariatric surgery under general anesthesia.

Official Title
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Effects of M-TAPA Block on Postoperative Pulmonary Functions in Laparoscopic Bariatric Surgery: A Randomized Controlled Study

Conditions
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Pulmonary Functions, Pain Management, Obesity, Morbid

Intervention / Treatment
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* Procedure: Modified thoracoabdominal nerves block through perichondrial approach (M-TAPA)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Between 18-65 years old ASA I-II-III risk group Patients whose approval was obtained through an informed consent form Will undergo laparoscopic bariatric surgery Patients who will cooperate for the PFT test Exclusion Criteria: <18 years and >65 years ASA ≥ IV 50% below the expected value in SFT Known diaphragmatic paralysis Having had a myocardial infarction within 1 month Dementia or confusion Lack of cooperation Those with respiratory disease Congestive heart failure Unstable hypertension Had thoracoabdominal surgery

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group M-TAPA<br> | Procedure: Modified thoracoabdominal nerves block through perichondrial approach (M-TAPA)<br>* application local anesthetic between internal oblique and transversus abdominis muscle at the level of 10th costal cartilage<br>|
| Group Control<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| FEV1/FVC ratio | Pulmonary function | during the procedure | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Numerical Rating Scale | pain assessment tool | during the procedure | 
| opioid consumption | need of opioid postoperatively | 24 hours after surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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obesity, pain management, pulmonary functions, respiratory function test