Erector Spinae Plane Block Versus Modified Thoracoabdominal Nerve Block for Pain Control After Laparoscopic Cholecystectomy

What this Trial Is About

Researchers are comparing two regional anesthesia techniques, the erector spinae plane block (ESPB) and the modified thoracoabdominal nerve block through the perichondrial approach (M-TAPA), to study their effectiveness in managing pain after laparoscopic cholecystectomy (LC). LC is a common minimally invasive surgery for gallbladder disease that usually causes less pain than open surgery, but many patients still experience moderate to severe pain after the procedure. The study aims to find out which block provides better pain relief by targeting different nerves and areas of the abdomen. Participants will be randomly assigned to receive either bilateral ESPB or bilateral M-TAPA during surgery under general anesthesia. Both groups will receive 20 ml of 0.25% bupivacaine injected under ultrasound guidance at specific anatomical sites: ESPB targets the erector spinae muscle near the spine, while M-TAPA targets the thoracoabdominal nerves beneath the costal cartilage. After surgery, all patients will receive standard pain medications, and rescue analgesics will be given if needed. During the study, patients will be monitored closely for pain levels, time until first pain medication is requested, total opioid use, patient satisfaction, quality of recovery, and any complications or side effects. Monitoring includes vital signs, pain scores, nausea, and vomiting assessments. The primary outcome is the time to first analgesic request within the first postoperative day, with additional assessments up to five days after surgery. The study lasts from the start of surgery through early postoperative recovery, focusing on improving pain control and patient comfort.

Erector Spina Plane Block Versus Modified Thoracoabdominal Nerve Block After Laparoscopic Cholecystectomy