Background and Aims Modified thoracoabdominal nerves block through perichondrial approach (M-TAPA) was first described as a peripheral nerve block by Tulgar in 2019, which provides an analgesic effective range in Th7–11 with a single puncture per side1. The efficacy and effective duration of the M-TAPA has been reported in several case reports; however its effects require further examination.
Methods With an IRB approval (No.2700) and registration (UMIN Clinical Trials Registry: UMIN000041137), 10 adult female patients scheduled for an open radical hysterectomy with vertical incision or laparotomy with a midline incision from under the xiphoid process to the symphysis pubis were enrolled. The primary outcome was the number of anesthetized dermatomes at 2 and 24 h postoperatively. Secondary outcomes included the numerical rating scale scores and the total amount of fentanyl used. Cadaveric evaluation was performed to assess the spread of the dye.
Results Patient characteristics are shown in table 1. The median number (interquartile range) of anesthetized dermatomes at 2 and 24 h postoperatively were 6 (5–7) and 6.5 (5–7) in the anterior cutaneous branch area, and 5 (4–7) and 7 (5–7) in the lateral cutaneous branch area, respectively. (Figure 1) There was an 85% chance of simultaneously acquiring the Th8–Th11 analgesic area including completely blocking Th9–10 in the anterior cutaneous branch area. Results are presented in table 2. Cadaveric evaluation showed the spread of the dye in Th8–11.
Conclusions M-TAPA may provide an analgesic effect in Th8–11 in the anterior cutaneous branch area.
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