فهرست نشریات علمی دسترسی آزاد ایران

Background and Objectives: It is known that both major abdominal surgeries and opioids used for postoperative pain management affect postoperative cognitive functions. The aim of this study is to investigate the effectiveness of thoracoabdominal nerve block through the perichondral approach (TAPA block) compared to conventional methods in preventing postoperative pain, reducing opioid consumption and saving cognitive functions in major abdominal surgeries.   Methods: Ninety patients who undergo major abdominal surgery were included in this observational study. Preoperative cognitive functions of the patients were evaluated via the Mini-Mental State Examination test (MMSE). Ultrasound guided TAPA block was applied to the patients in the TAPA group. IV morphine was administered to patients who could not undergo TAPA. All patients received intravenous Patient-Controlled Analgesia devices (PCA) with morphine. Pain assessment was documented with the numeric rating scale (NRS) at postoperative hours 1, 2, 6, 12, 24. Opioid consumption in the postoperative 24-hour period was recorded. MMSE was performed preoperatively, after recovery, and on postoperative days 1and 3.   Results: Demographic data, operation durations, pre-, intra-, and postoperative body temperatures, and preoperative MMSE scores of both groups were similar. Total opioid consumption, recovery times, and all postoperative NRS values in the TAPA group were significantly lower. There was no difference between groups in terms of cognitive functions on the postoperative immediate, 1st, and 3rd days.   Conclusion: In major abdominal surgery, TAPA Block reduced opioid consumption, provided early recovery, and provided effective pain management. However, TAPA block did not make any difference in terms of cognitive function.