Oblique Subcostal Transversus Abdominis Plane Block Versus Transmuscular Quadratus Lumborum Block for Pain Management in Laparoscopic Gynecological Surgery

Patients between the ages of 18-65, who will undergo laparoscopic gynecological surgery, American Society of Anesthesiologists (ASA) class I-II-III, Body Mass Index (BMI) in the range of 18-25 kg/m², and who will use 3 or 4 trocar for surgery will be included in the study. Patients will be randomized into two groups. OSTAP block will be performed for OSTAPB group and TQL block will be performed for TQLB group. Patients will be administered postoperative 4x500 mg iv paracetamol as needed (if Visual Analogue Scale (VAS) score is 4 or higher). If the VAS score remains at 4 or higher 30 minutes after paracetamol administration, 1 mg/kg iv tramadol will be administered as a rescue analgesic (with a daily maximum dose of 400 mg). The primary outcome is to compare the total analgesic consumption within the first 24 hours after surgery. The secondary outcome is to compare the time to the first postoperative analgesic requirement, VAS scores at rest and on movement, and assess the impact of these two blocks on the quality of recovery using the QOR-15 scale

Inclusion criteria

• Ages of 18-65
• Patients who will undergo laparoscopic gynecological surgery
• ASA I-II-III patients
• Body Mass Index (BMI) in the range of 18-25 kg/m²
• Patients who will undergo surgery using 3 or 4 trocars

Exclusion criteria

• ASA IV-V
• Patients with a known or suspected allergy to local anesthetics
• Coagulopathy
• Injection site infection
• Severe neurological or psychiatric disorders
• Severe cardiovascular disease
• Liver failure
• Kidney failure (glomerular filtration rate <15 ml/min/m²)
• Chronic opioid use (>6 months)
• Surgical durations less than 45 minutes or greater than 120 minutes