ORIGINAL RESEARCH article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1582428
Ultrasound-guided Modified Thoracoabdominal Nerve Block for Postoperative Analgesia in Laparoscopic Renal Cyst Decompression: A Randomized Double-blind Controlled Trial
Provisionally accepted
- First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Background: Laparoscopic renal cyst decompression (LRCD) is a common procedure in urology, but postoperative pain remains a significant challenge. While regional nerve blocks provide more targeted pain relief, there is no universally accepted pain management strategy for LRCD. The ultrasound-guided modified thoracoabdominal nerve block (M-TAPA) may offer effective analgesia by blocking the anterior and lateral branches of the intercostal nerves (T5-T12). However, its efficacy in LRCD has not been thoroughly evaluated.Objective: This study aimed to assess the efficacy and safety of unilateral M-TAPA in reducing postoperative pain and opioid consumption in patients undergoing LRCD, and to evaluate its potential benefits in enhancing recovery.2 Methods: In this randomized, double-blind, controlled trial, 61 patients undergoing LRCD were assigned to either the M-TAPA group (n = 31) or the Control group (n = 30). The M-TAPA group received ultrasound-guided nerve block, while the Control group received a placebo injection . Postoperative pain was assessed using the numerical rating scale (NRS) over a 48-hour period. Additional outcomes included opioid consumption and opioid-related side effects, such as nausea and vomiting.The M-TAPA group had significantly lower NRS scores at all time points compared to the Control group, with the largest difference observed at 6 hours postoperatively (4.27 ± 0.83 in the Control group vs. 2.19 ± 0.54 in the M-TAPA group). Repeated measures ANOVA revealed a significant interaction between time and treatment (F = 20.813, p < 0.001). Opioid consumption was reduced by 22% in the M-TAPA group over 48 hours (P < 0.001), and the need for antiemetic drugs was significantly lower (P = 0.020). No M-TAPA-related complications were observed.M-TAPA was found to be an effective method for reducing postoperative pain and opioid consumption in patients undergoing LRCD.
Keywords: Modified thoracoabdominal nerve block, Laparoscopic renal cyst decompression, Postoperative analgesia, ultrasound, randomized controlled trial
Received: 17 Mar 2025; Accepted: 16 Jun 2025.
Copyright: © 2025 Wan, Wei, Dong, Jin, Cao and Yuan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jun Dong, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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