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Article Abstract
Background: Laparoscopic renal cyst decompression (LRCD) is a common procedure in urology, but postoperative pain remains a significant challenge. While regional nerve blocks provide more targeted pain relief, there is no universally accepted pain management strategy for LRCD. The ultrasound-guided modified thoracoabdominal nerve block (M-TAPA) may offer effective analgesia by blocking the anterior and lateral branches of the intercostal nerves (T5-T12). However, its efficacy in LRCD has not been thoroughly evaluated.
Objective: This study aimed to assess the efficacy and safety of unilateral M-TAPA in reducing postoperative pain and opioid consumption in patients undergoing LRCD, and to evaluate its potential benefits in enhancing recovery.
Methods: In this randomized, double-blind, controlled trial, 61 patients undergoing LRCD were assigned to either the M-TAPA group ( = 31) or the Control group ( = 30). The M-TAPA group received ultrasound-guided nerve block, while the Control group received a placebo injection. Postoperative pain was assessed using the numerical rating scale (NRS) over a 48-h period. Additional outcomes included opioid consumption and opioid-related side effects, such as nausea and vomiting.
Results: The M-TAPA group had significantly lower NRS scores at all time points compared to the Control group, with the largest difference observed at 6 h postoperatively (4.27 ± 0.83 in the Control group vs. 2.19 ± 0.54 in the M-TAPA group). Repeated measures ANOVA revealed a significant interaction between time and treatment ( = 20.813, < 0.001). Opioid consumption was reduced by 22% in the M-TAPA group over 48 h ( < 0.001), and the need for antiemetic drugs was significantly lower ( = 0.020). No M-TAPA-related complications were observed.
Conclusion: M-TAPA was found to be an effective method for reducing postoperative pain and opioid consumption in patients undergoing LRCD.
Clinical Trial Registration: www.chictr.org.cn.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271125 | PMC |
| http://dx.doi.org/10.3389/fmed.2025.1582428 | DOI Listing |
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