The Effect of Local Anesthetic Infiltration or Erector Spina Plan Block on Stress Hormone Response
Condition: Post Operative Pain; Erector Spinae Plane Block; Inguinal Hernia
MeSH terms: Pain, Postoperative; Hernia, Inguinal
Study type: Interventional

Summary: 
      Laparoscopic cholecystectomy is one of the most common operations in abdominal surgery.

      Effective analgesia in the postoperative period; It is of great importance in terms of
      acceleration of recovery, prevention of atelectasis, reduction of endocrine and metabolic
      stress response, reduction of thromboembolic complications, protection of cognitive
      functions, prevention of chronic pain development, and reduction of hospital stay .
      Intravenous paracetamol, NSAID/cyclooxygenase-2 selective inhibitors, opioids, local
      anesthetic infiltration in the port area, intraperitoneal local anesthetic insufflation or
      plan blocks can be used in the treatment of postoperative pain after laparoscopic
      cholecystectomy. Operation, tissue trauma, anesthesia, drugs given to the patient, type of
      anesthesia, blood loss, temperature changes and pain cause postoperative stress response
    

Detailed description: 
      Laparoscopic cholecystectomy is one of the most common operations in abdominal surgery.
      Abdominal and shoulder pain are frequently seen in patients in the postoperative period.

      Laparoscopic surgery is considered the gold standard in abdominal surgery because of its low
      cost, less postoperative pain, early mobilization, and short hospital stay. Effective
      analgesia in the postoperative period; It is of great importance in terms of acceleration of
      recovery, prevention of atelectasis, reduction of endocrine and metabolic stress response,
      reduction of thromboembolic complications, protection of cognitive functions, prevention of
      chronic pain development, and reduction of hospital stay . Intravenous paracetamol,
      NSAID/cyclooxygenase-2 selective inhibitors, opioids, local anesthetic infiltration in the
      port area, intraperitoneal local anesthetic insufflation or plan blocks can be used in the
      treatment of postoperative pain after laparoscopic cholecystectomy. In laparoscopic
      cholecystectomy operations, the results of pain reduction and analgesic consumption in
      incisional local anesthetics are variable.

      Operation, tissue trauma, anesthesia, drugs given to the patient, type of anesthesia, blood
      loss, temperature changes and pain cause postoperative stress response .

      In various surgeries, regional anesthesia for post-operative purposes, plan blocks,
      infiltration or insufflation methods were found to suppress the stress response.

      In this study, the investigator aimed to compare the effects of local anesthetic infiltration
      at the wound site and erector spine plane block on stress hormone response and postoperative
      analgesia in patients who will undergo laparoscopic cholecystectomy surgery.
    

Intervention name(s): wound site local anesthesic infiltration; Erector spina plane block
Intervention type(s): Procedure; Procedure
Intervention description(s): : at the end of the operation; 0.5% bupivacaine (1mg/kg) was infiltrated into the fascia muscles and preperitoneal space in equal doses to the wound at the 4 trocar entry site.; Erector spina block was applied to the group, after the end of the operation, the patients were placed in the left lateral decubitus position and the spinous process of the 8th thoracic vertebra was marked under sterile conditions. After visualizing the spinous process with ultrasound (EsoateMyLab™30 Gold, 8-18 MHz, Genova, Italy), the linear probe (8-12 MHz) was shifted 3 cm laterally from the midline in the cranial-caudal direction. Trapezius, erector spinae muscles, transverse process and pleura were visualized, and 20ml of 0.25% bupivacaine was injected into the validated interval by directing the peripheral nerve block needle in the cranio-caudal direction.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Cholecystectomy, Laparoscopic; Erector spinae plane block; analgesia; cortisol; prolactin