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Author(s): Hande Güngör [sup.1], Bahadir Ciftci [sup.1], Selcuk Alver [sup.1], Birzat Emre Gölboyu [sup.2], Yasar Ozdenkaya [sup.3], Serkan Tulgar [sup.4] Author Affiliations: (1) grid.411781.a, 0000 0004 0471 9346, Department of [...], Purpose Modified thoracoabdominal nerves block through perichondrial approach (M-TAPA) targets thoracoabdominal nerves. Our primary aim was to compare M-TAPA vs local infiltration on pain management in patients underwent laparoscopic cholecystectomy (LC) surgery. Methods Patients with ASA class I-II patients aged between 18 and 65 years scheduled for elective LC under general anesthesia were enrolled in the study. There were two randomized groups: Group M: M-TAPA group (n = 30) and the local infiltration (LI) group (n = 30). M-TAPA was performed with totally 40 ml 0.25% bupivacaine in the M group. LI was performed in infiltration group. The primary outcome of the study was pain score in the PACU, the secondary outcomes were the patient satisfaction scores, rescue analgesic need, and adverse effects during the 24-h postoperative period. Results The static NRS scores were significantly lower in Group M at the postoperative first 4 h (p = 0.001). There was a significant decrease in the dynamic NRS scores in Group M at the postoperative first 16 h (p = 0.001). The incidence of nausea was significantly higher in the LI group (12 vs. 5 patients, p = 0.047). The need for rescue analgesia was significantly lower in Group M (p = 0.009). The patient satisfaction scores were significantly higher in Group M (p = 0.001). Conclusion M-TAPA provides superior analgesia compared to LI in patients undergoing LC.

Objective We aimed to evaluate the effectiveness of ultrasound-guided facia iliaca compartment (FIC) and erector spinae plane (ESP) blocks in managing postoperative pain after total hip arthroplasty surgery. Methods A total of 60 patients were randomized into 2 groups (n  = 30): one that received FIC blocks and one that received ESP blocks. FIC and ESP blocks were performed with 30 mL 0.25% bupivacaine at the end of the surgery. The patients received intravenous tramadol and patient-controlled postoperative analgesia. The pain scores, opioid consumption, and adverse events were recorded. Results The dynamic pain scores on movement in the postoperative first hour were significantly lower in the ESP block group than in the FIC block group (3 [2–4] vs 4 [2–5], respectively; P  = .035). Data are expressed as median (25th–75th percentiles). Postoperative opioid consumption within the first postoperative 8 hours was significantly higher in the FIC block group than in the ESP block group (80 mg [61–100] vs 100 mg [80–120], respectively; P  = .010). The adverse effects of opioids did not differ between the 2 groups. Conclusion ESP and infrainguinal FIC blocks provided similar postoperative analgesia 24 hours after total hip arthroplasty. The ESP block is more beneficial than the FIC block in terms of pain scores and opioid consumption in the early hours of the postoperative period. Trial registration www.ClinicalTrials.gov (ID: NCT05621161). [ABSTRACT FROM AUTHOR]

Objective Moderate to severe pain may occur following arthroscopic shoulder surgery. An erector spinae plane block (ESPB) may be used for painful conditions of the shoulder. The primary hypothesis of this trial is that ultrasound-guided ESPB would provide effective analgesia by reducing opioid consumption. The secondary hypothesis is that ESPB would result in low pain scores and reduce the use of rescue analgesia. Design Randomized prospective double-blind study. Setting Academic university hospital. Subjects Sixty patients aged between 18 and 65 years designated as American Society of Anesthesiologists (ASA) class I or II who underwent unilateral arthroscopic shoulder surgery under general anesthesia were included in the study. Methods Patients were equally divided into two groups—either the ESPB group (n=30) or the sham block group (n=30). ESPB was performed with 30 mL 0.25% bupivacaine at the T2 level in the ESPB group and sham block with 30 mL saline at the T2 level in the sham block group. Twenty minutes before the end of the operation, 100 mg tramadol was administered intravenously to the patients. Intravenous ibuprofen 400 mg 3 × 1 was ordered for the patients during the postoperative period. A patient control analgesia device including a dose of 10 µg/mL fentanyl was connected to the patients. Results There were no statistical differences between groups in terms of demographical data. Postoperative fentanyl consumption was significantly lower in the ESPB group than in the sham block group (96.66 µg ±105.57 µg and 230 µg ±247.17 µg, respectively) (P =0.009). The need for rescue analgesia was significantly lower in the ESPB group than in the sham block group (26.66 mg ±35.43 mg and 48.5 mg ±35.45 mg, respectively) (P =0.020). Overall, the visual analog scale scores were significantly lower in the ESPB group than in the sham block group. Conclusions ESPB may provide effective analgesia treatment following arthroscopic shoulder surgery. [ABSTRACT FROM AUTHOR]