The goal of this clinical trial is to learn if the timing of ultrasound-guided transversus abdominis plane block (US-TAP block) administration (preoperative vs. postoperative) affects the perioperative analgesia nociception index (ANI) in adult patients undergoing laparoscopic cholecystectomy. The main questions it aims to answer are:
* Does the timing of the US-TAP block significantly influence intraoperative ANI values? * Does the difference in US-TAP block timing and subsequent ANI values correlate with actual patient recovery, postoperative pain scores (VAS), and complication rates?
If there is a comparison group: Researchers will compare the experimental group (Group A: US-TAP block before surgical incision) to the control group (Group B: US-TAP block after wound closure) to see if early block administration provides superior intraoperative pain suppression and reduces postoperative pain or analgesic consumption.
Participants will:
* Undergo standard general anesthesia induction and maintenance. * Receive a bilateral US-TAP block with a total of 30 mL of 0.2% ropivacaine, administered either before incision (Group A) or after closure (Group B). * Be monitored via standard monitoring devices alongside an ANI monitor. * Use an intravenous patient-controlled analgesia (IV-PCA) pump for 24 hours after surgery. * Participate in postoperative assessments to measure pain scores (VAS), rescue analgesic consumption, satisfaction, and complications at specific intervals up to 24 hours post-surgery.
Patients scheduled to undergo laparoscopic cholecystectomy.
Aged 19 years or older.
American Society of Anesthesiologists (ASA) physical status I, II, or III.
Patients who lack the capacity to understand the study examinations or perform the assessment procedures.
Patients with coagulation deficiencies or bleeding disorders.
Patients with cardiac arrhythmias or those with an implanted cardiac pacemaker.
Patients taking medications that affect the autonomic nervous system, including beta-blockers and opioid analgesics.
Parallel
Preoperative US-TAP Block
Procedure/SurgeryUltrasound-guided transversus abdominis plane block administered immediately after general anesthesia induction, prior to surgical incision, using 0.2% ropivacaine (total 30 mL).
Postoperative US-TAP Block
Procedure/SurgeryUltrasound-guided transversus abdominis plane block administered after surgical wound closure is completed, before discontinuing inhalation anesthetics, using 0.2% ropivacaine (total 30 mL).
Intraoperative Analgesia Nociception Index (ANI)
Postoperative Pain Intensity via Visual Analogue Scale (VAS)
Cumulative Postoperative Rescue Analgesic Consumption
Incidence of Postoperative Complications and Adverse Events
Patient Satisfaction Score for Postoperative Pain Management
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This trial is not recruiting at the moment. You can still explore other options:
