Superficial Plane Blocks for Analgesia After Laparoscopic Cholecystectomy

The study will prospectively enroll 90 adults aged 18 to 85 years who are scheduled for elective laparoscopic cholecystectomy at Bursa Yuksek Ihtisas Training and Research Hospital. The choice of postoperative analgesic technique will be made by the responsible anesthesiologist as part of routine clinical care; the investigators will not assign participants to an analgesic technique. Participants will be evaluated according to the routine care they receive: rectointercostal plane block, EXORA block, or intravenous patient-controlled analgesia. Investigators will record demographic and clinical characteristics, operative and anesthetic information, the analgesic technique used, local anesthetic type and volume when applicable, and tramadol use. Pain at rest and during movement will be measured with the Numeric Rating Scale at 0, 2, 4, 6, 12, and 24 hours postoperatively. For participants receiving a plane block, dermatomal sensory spread from T4 through T12 will be assessed by pinprick testing at 30 minutes after surgery. The study will also record cumulative tramadol consumption during the first 24 postoperative hours, postoperative nausea and vomiting, and block-related complications.

Inclusion criteria

• Age 18 to 85 years
• Scheduled to undergo elective laparoscopic cholecystectomy
• American Society of Anesthesiologists physical status I, II, or III
• Provision of written informed consent

Exclusion criteria

• Age younger than 18 years or older than 85 years
• Known allergy to local anesthetics
• Coagulopathy
• Presence of infection
• Pregnancy
• Cognitive impairment
• Body mass index greater than 35 kg/m²