Effects of M-TAPA Block on Pulmonary Functions

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

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, The investigators 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.

Study Overview

• Status: Completed
• Conditions: Obesity, Morbid; Pain Management; Pulmonary Functions
• Intervention / Treatment: Procedure: Modified thoracoabdominal nerves block through perichondrial approach (M-TAPA)

• Study Type: Observational
• Enrollment (Actual): 1

Contacts and Locations

Study Locations

• Turkey
  • Kozlu
    • Zonguldak, Kozlu, Turkey, 67600
      • Zonguldak Bülent Ecevit University Medicine Faculty

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Probability Sample

Study Population

Patients aged 18-65 who will undergo ASA I-III laparoscopic bariatric surgery

Description

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

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

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

What is the study measuring?

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
opioid consumption	need of opioid postoperatively	24 hours after surgery
Numerical Rating Scale	pain assessment tool (minimum: 0, maximum: 10)	during the procedure

Collaborators and Investigators

• Sponsor: Zonguldak Bulent Ecevit University

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2023
• Primary Completion (Actual): May 30, 2024
• Study Completion (Actual): July 1, 2024

Study Registration Dates

• First Submitted: November 20, 2023
• First Submitted That Met QC Criteria: November 27, 2023
• First Posted (Actual): November 28, 2023

Study Record Updates

• Last Update Posted (Actual): April 22, 2025
• Last Update Submitted That Met QC Criteria: April 16, 2025
• Last Verified: April 1, 2025

More Information

Terms related to this study

• Keywords: obesity; respiratory function test; pain management; pulmonary functions
• Additional Relevant MeSH Terms: Nutrition Disorders; Overnutrition; Body Weight; Overweight; Obesity; Obesity, Morbid
• Other Study ID Numbers: 2023/04-4

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No