Effectiveness of Thoracoabdominal Nerve Block (M-TAPA) on Postoperative Pain Relief in Laparoscopic Hysterectomy

March 16, 2026 updated by: Istinye University

Effectiveness of Modified-Thoracoabdominal Nerve Block With Perichondrial Approach (M-TAPA) on Postoperative Pain Relief in Laparoscopic Hysterectomy Surgery: A Prospective, Randomized, Double-Blind, Controlled Study

This study aims to investigate the effectiveness of a specific regional anesthesia technique, the Modified-Thoracoabdominal Nerve Block through a Perichondrial Approach (M-TAPA), on reducing pain after laparoscopic hysterectomy surgery. Hysterectomy is a common major surgical procedure, and managing postoperative pain is crucial for patient comfort and faster recovery.

Participants will be randomly assigned to one of two groups:

The M-TAPA Group: Patients will receive the nerve block using a local anesthetic (bupivacaine) before the surgery begins.

The Control Group: Patients will receive standard postoperative pain management without the nerve block.

The primary goal is to determine if the M-TAPA block reduces the total amount of opioid (morphine) used by patients in the first 24 hours after surgery. The researchers will also evaluate pain scores (NRS), the time until the first request for additional pain medication, patient satisfaction, and any side effects like nausea or vomiting

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

60

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Aged between 18 and 70 years
  • ASA (American Society of Anesthesiologists) physical status I, II, or III
  • Scheduled for elective laparoscopic hysterectomy
  • Voluntary participation with signed informed consent

Exclusion Criteria:

  • Hepatic or renal disease.
  • Coagulation disorders.
  • Uncontrolled cardiovascular or respiratory diseases.
  • Psychiatric disorders.
  • History of allergy to local anesthetics.
  • History of alcoholism, drug or substance abuse.
  • Body Mass Index (BMI) greater than 35 kg/m2
  • Refusal of the regional block procedure

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: Control Group
Experimental: M-TAPA Group
Procedure: Modified-Thoracoabdominal Nerve Block through a Perichondrial Approach (M-TAPA)
Under ultrasound guidance, a 22-gauge peripheral block needle is inserted at the costochondral angle (9th-10th ribs). After confirming the position, 20 ml of 0.25% bupivacaine is injected bilaterally into the lower part of the chondrium.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Morphine consumption
Time Frame: First 24 hours postoperatively
Total amount of morphine (mg) used via Patient-Controlled Analgesia (PCA)
First 24 hours postoperatively

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Postoperative Pain Scores (NRS)
Time Frame: Baseline (Hour 0), 1, 2, 4, 6, 12, and 24 hours postoperatively
Numerical Rating Scale (0=no pain, 10=worst pain)
Baseline (Hour 0), 1, 2, 4, 6, 12, and 24 hours postoperatively
Rescue analgesic drug consumption
Time Frame: Within the first 24 hours postoperatively
The amount of rescue analgesic in mg required by the patient will be recorded for the first 24 hours.
Within the first 24 hours postoperatively
Incidence of postoperative nausea and vomiting
Time Frame: Within the first 24 hours postoperatively
Number of patients developing postoperative nausea and vomiting will be recorded for the first 24 hours
Within the first 24 hours postoperatively

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Istinye University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

April 15, 2026

Primary Completion (Estimated)

October 15, 2026

Study Completion (Estimated)

November 15, 2026

Study Registration Dates

First Submitted

March 16, 2026

First Submitted That Met QC Criteria

March 16, 2026

First Posted (Actual)

March 19, 2026

Study Record Updates

Last Update Posted (Actual)

March 19, 2026

Last Update Submitted That Met QC Criteria

March 16, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • anestezi tapa

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

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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