An observational study in Hysterectomy and Postoperative Pain, sponsored by Namik Kemal University. Completed at 1 site in Turkey (Türkiye). Open to female participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2026-07-31.
Sponsored by Namik Kemal University · Observational
This single-center retrospective cohort study evaluated the effect of the modified thoracoabdominal nerves block through a perichondrial approach (M-TAPA) on postoperative analgesia in patients undergoing elective total laparoscopic hysterectomy. Medical records of 60 patients who underwent surgery at Tekirdag Namik Kemal University Faculty of Medicine Hospital between December 25, 2023 and December 25, 2024 were retrospectively reviewed. Patients who received bilateral ultrasound-guided M-TAPA block were compared with patients who received standard general anesthesia and systemic analgesia without M-TAPA block. The primary outcome was cumulative tramadol consumption during the first 24 postoperative hours. Secondary outcomes included postoperative Visual Analog Scale (VAS) pain scores at predefined time points, rescue analgesic requirements, postoperative nausea and vomiting, Quality of Recovery-15 (QoR-15) scores, and block-related complications.
Postoperative pain following total laparoscopic hysterectomy remains an important clinical concern because inadequate analgesia may delay mobilization, prolong recovery, increase opioid consumption, and reduce patient satisfaction. Ultrasound-guided fascial plane blocks have become an important component of multimodal analgesia strategies. The modified thoracoabdominal nerves block through a perichondrial approach (M-TAPA) is a relatively new regional anesthesia technique that provides analgesia of the anterior thoracoabdominal wall by targeting the thoracoabdominal nerves beneath the costal cartilage.
This single-center retrospective cohort study reviewed the medical records of patients who underwent elective total laparoscopic hysterectomy at Tekirdag Namik Kemal University Faculty of Medicine Hospital between December 25, 2023 and December 25, 2024. After application of predefined inclusion and exclusion criteria, 60 patients were included in the analysis. Thirty patients received bilateral ultrasound-guided M-TAPA block with 20 mL of 0.25% bupivacaine on each side (total volume: 40 mL) in addition to standard general anesthesia, whereas 30 patients received standard general anesthesia and systemic analgesia without M-TAPA block.
The primary outcome was cumulative tramadol consumption during the first 24 postoperative hours. Secondary outcomes included postoperative Visual Analog Scale (VAS) pain scores at 0, 6, 12, and 24 hours after surgery, rescue analgesic requirements, postoperative nausea and vomiting, Quality of Recovery-15 (QoR-15) scores at 24 hours, and block-related complications documented in the medical records.
The study was approved by the Tekirdag Namik Kemal University Non-Interventional Clinical Research Ethics Committee (Approval No. 2025.11.01.11) before data collection and was conducted in accordance with institutional and ethical standards.
5,093 studies on the registry are indexed under Pain, Postoperative; 1,140 are open to participants now.
This study's enrollment of 60 is below the median of 102 across 608 observational studies indexed under Pain, Postoperative.
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Female patients aged 18-65 years with ASA physical status I-II who underwent elective total laparoscopic hysterectomy at Tekirdag Namik Kemal University Faculty of Medicine Hospital between December 25, 2023, and December 25, 2024.
Exclusion Criteria:
Patients who underwent elective total laparoscopic hysterectomy under general anesthesia and received bilateral ultrasound-guided modified thoracoabdominal nerves block through a perichondrial approach (M-TAPA) in addition to standard perioperative analgesia.
Procedure: Modified thoracoabdominal nerves block through a perichondrial approach (M-TAPA)
Patients who underwent elective total laparoscopic hysterectomy under general anesthesia and received standard perioperative analgesia without modified thoracoabdominal nerves block through a perichondrial approach (M-TAPA).
Bilateral ultrasound-guided modified thoracoabdominal nerves block through a perichondrial approach using 20 mL of 0.25% bupivacaine on each side (total volume: 40 mL), performed before surgical incision as part of multimodal analgesia.
Cumulative tramadol consumption during the first 24 postoperative hours
Total tramadol consumption delivered by patient-controlled analgesia (PCA) during the first 24 postoperative hours.
Time frame: During the first 24 postoperative hours
Postoperative pain intensity
Postoperative pain intensity assessed using the Visual Analog Scale (VAS). The VAS ranges from 0 to 10, where 0 indicates no pain, 10 indicates the worst imaginable pain, and higher scores indicate greater pain intensity.
Time frame: At 0, 6, 12, and 24 hours after surgery
Quality of recovery (QoR-15)
Postoperative recovery quality assessed using the validated Quality of Recovery-15 (QoR-15) questionnaire. The QoR-15 score ranges from 0 to 150, with higher scores indicating better postoperative recovery.
Time frame: At 24 hours after surgery
Rescue analgesic requirements
Requirement for additional rescue analgesic medication when postoperative pain remained inadequately controlled despite patient-controlled analgesia.
Time frame: During the first 24 hours after surgery
Postoperative nausea and vomiting
Incidence of postoperative nausea and vomiting documented in the medical records.
Time frame: During the first 24 hours after surgery
Block-related complications
Complications related to bilateral ultrasound-guided modified thoracoabdominal nerves block through a perichondrial approach documented in the medical records.
Time frame: During the first 24 postoperative hours
Plan to share: No
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Namik Kemal University