Postoperative Analgesic Effectiveness of the Modified Thoracoabdominal Nerve Block Through a Perichondrial Approach in Total Laparoscopic Hysterectomy

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.

Inclusion Criteria: * Female patients aged 18 to 65 years. * American Society of Anesthesiologists (ASA) physical status I or II. * Undergoing elective total laparoscopic hysterectomy under general anesthesia. * Availability of complete perioperative and postoperative medical records. Exclusion Criteria: * Neurological disorders affecting pain perception. * Coagulopathy or bleeding disorders. * Known allergy to local anesthetics. * Chronic opioid use before surgery. * Body mass index (BMI) greater than 35 kg/m². * Incomplete medical records.