Subcostal Transversus Abdominus , Erector Spinae and Paravertebral Blocks Effects on Laparoscopic Cholecystectomy Cases
Condition: Comparison; Evaluation
Study type: Interventional

Summary: 
      Sixty patients with ASA (American Society of Anesthesiologist) I-II physical status between
      the ages of 20-60 were randomized into three groups: TAP block group (Group T), ESP block
      group (Group E) and PVB group (Group P). Bilateral 20cc (total 40cc for each patient) 0.25%
      bupivacaine was applied by ultrasound (US) guidance. Intraoperative vital signs (heart rate,
      blood pressure, and saturation), Train-of-four (TOF) values, additional dose of opioid and
      muscle relaxant needs, complications were recorded. Postoperative side effects (nausea,
      vomiting, itching, tremor), the need for additional postoperative analgesia, Visual Analog
      Scale (VAS) scores were noted.
    

Detailed description: 
      Cases; under the age of 20 - over 60, emerge and bleeding, outside the ASAI-II functional
      status, undergo surgery other than laparoscopic cholecystectomy, refused to participate in
      the study, allergic to local anesthetic agents, with a body mass index (BMI) >30, have
      contraindications for regional anesthesia (sepsis, local infection, coagulopathy, heart
      disease, hypovolemia, cases that do not want regional anesthesia), pregnant were not included
      in the study.Twenty patients in each group and a total of 60 patients were included the study
      by power analysis. According to the randomized, single-blind, closed-envelope method,
      patients were randomly divided into three groups.

      Group T (Subcostal TAP Block): 40 cc (20cc+20cc) 0.25 % Bupivacaine for bilateral application
      Group E (ESP Block): 40 cc (20cc+20cc) 0.25% Bupivacaine for bilateral application Group P
      (PVB): 40 cc (20cc+20cc) 0.25% Bupivacaine for bilateral application were prepared.
    

Intervention name(s): TAP Block group; Paravertebral block group; Erector spinae block group
Intervention type(s): Other; Other; Other
Intervention description(s): TAP Block: the US probe was placed on the imaginary line connecting the anterior superior iliac spine and the umbilicus. The ilioinguinal and iliohypogastric nerves in the fascia of the internal obliq and transverse abdominis muscles were visualized by US. A total of 40 ml of local anesthetic was infiltrated ESP Blok : a 100 mm 21G peripheral nerve block needle was inserted between the erector spinae muscle and the transverse process structures in an in-plane section guided by US from the T7-8 level. 40 ml of the prepared solutions were injected PVB: In the lateral decubitus position, the cranial to caudal transverse processes and the superior costotransverse ligament and the pleura were visualized from the T7-8 level in the in-plane section under US guidance. A 100 mm 21G peripheral nerve block needle was advanced until it passed through the superior costotransverse ligament. A total of 40 ml of injections were made; In the lateral decubitus position, the cranial to caudal transverse processes and the superior costotransverse ligament and the pleura were visualized from the T7-8 level in the in-plane section under US guidance. A 100 mm 21G peripheral nerve block needle (SonoPlex Stim Cannula, PAJUNK®, USA) was advanced until it passed through the superior costotransverse ligament. A total of 40 ml of injections were made bilaterally in the form of 20+20 ml.; In the lateral decubitus position, a 100 mm 21G peripheral nerve block needle (SonoPlex Stim Cannula, PAJUNK®,USA) was inserted between the erector spinae muscle and the transverse process structures in an in-plane section guided by US from the T7-8 level. A total of 40 ml of the prepared solutions were injected bilaterally as 20+20 ml.
Other intervention name(s): Paravertebral block group; Erector spinae block group; PVB group; ESP block group
Allocation: Randomized
Intervention model: Factorial Assignment
Intervention model description: randomized, single-blind, closed-envelope method
Masking: Single (Participant)
Primary purpose: Supportive Care
Keywords: plane blocks; ultrasonography; bupivacaine