Please select the eligibility criteria that correspond to the clinical trial below.
Title: Efficacy of Ultrasound-Guided Erector Spinae Plan Block on Postoperative Pain After Laparoscopic Cholecystectomy Under General Anesthesia. Randomized, Controlled Trial
Brief Summary: Laparoscopic cholecystectomy is a widely employed procedure in ambulatory surgery. Pain after laparoscopic cholecystectomy arises significantly from port site incisions in the anterior abdominal wall. Innervation of the anterior abdominal wall is segmentally supplied by pain afferents in the plane of fascia between transversus abdominis and the internal oblique muscles. Opioids analgesia is used to control postoperative pain, but it carries the risk of increased nausea and vomiting, ileus and sedation that may delay hospital discharge.

Several techniques have been tried as.neuroaxial narcotics, intraperitoneal lavage of local anesthetic and transversus abdominis plan (TAP) block and successfully reduced opioid use and improve postoperative analgesia.

The ultrasound-guided erector spinae plan(ESP) block is a recently described technique which produces reliable unilateral analgesia at thoraco-lumbar dermatomes. ESP block carries the advantages of being simple, safe, easily recognizable by ultrasound, and a catheter can be threaded to extend the duration of analgesia.

Few case series reported the efficacy of (US)-guided ESP blocks in reducing postoperative pain and opioids consumption.

Because of that, the investigators aimed to test the hypothesis that US-guided ESP blocks can decrease opioid consumption during the first 24 h after of laparoscopic cholecystectomy in comparison with the conventional systemic analgesia.


Options:
A: Inclusion Criteria:

* 60 ASA I- II adult patients
* 20-60 years old
* elective laparoscopic cholecystectomy
* Body mass index (BMI) less than 35
* Port sites at or above thoracic T 10 dermatome

Exclusion Criteria:

* Allergy to amino-amide local anesthetics
* Presence of coagulopathy
* Local skin infection at the needle puncture sites
* Preoperative chronic dependence upon opioid and NSAID medications
* Liver or renal insufficiency
* History of psychiatric or neurological disease
* Deafness
* previous open surgery that need the conversion of laparoscopic to open surgery or manipulations more than expected with more tissue trauma
* American Society of Anesthesiologists (ASA) above Class II
B: Inclusion Criteria:

* ASA I-II
* Age 18-65 years
* Undergoing elective lomber disc hernia

Exclusion Criteria:

* obesity
* ASA III - IV
* infection of the skin at the site of needle puncture area
* patients with known allergies to any of the study drugs
* coagulopathy
C: Inclusion Criteria:

* ASA I, II
* Laparoscopic cholecystectomy
* Elective surgery

Exclusion Criteria:

* Patient refusal
* Coagulation disorders
* Known allergies to local anesthetics
* Other contraindications to regional anesthesia
* Infection or anatomic anomalies on injection site
* Uncontrolled hypertension
* Severe liver or kidney disease
* Pregnancy
* Known depression or psychiatric disorders, dementia
* Drug or alcohol abuse
* Inadequate command of Greek language
D: Inclusion Criteria:

* Age between 18 and 65 years
* American Society of Anesthesiologists physical status I-II-III
* Body mass index between 18-30 kg/m2
* Patients undergoing elective video assiste thoracoscopic surgery

Exclusion Criteria:

* Patient refusing the procedure
* History of chronic analgesic or opioid therapy
* History of local anesthetic allergy
* Infection in the intervention area
* Emergency surgery

Answer: A