This study aims to compare the analgesic effect of retro superior costotransverse ligament space block vs erector spinae plane block to Achieve high-quality perioperative opioid-sparing effect and postoperative analgesia after laparoscopic cholecystectomy with optimum hemodynamic stability and high patient and surgeon satisfaction
patient acceptance
Age: 21-64 years old.
Sex: both sexes.
Physical status: ASA I & II.
Known hypersensitivity to lidocaine or bupivacaine.
Patients with respiratory insufficiency.
Coagulation disorders or taking drugs affect surgical hemostasis.
Parallel
Retrosuperior costotransverse ligament block group
Procedure/SurgeryThe patient will receive retrosuperior costotransverse ligament block
Erector spinae block group
Procedure/SurgeryThe patient will receive erector spinae block.
The time to first call to rescue analgesia
The time to first call to rescue analgesia( the interval between the block injection till the NRS more than or equal 4) (naluphine) will be recorded
To assess block characteristics (block performance time)
To assess block characteristics (block performance time) in minutes
Total intraoperative fentanyl consumption
Total intraoperative fentanyl required other than the induction dose in micrograms
Pain intensity by Numerical Rating Scale
Analgesic parameters (Pain intensity at rest and at movement) by using Numerical Rating Scale (NRS) which will explained to patient as follows:0=no pain and 10= worst pain
total amount of rescue analgesia
total amount of rescue analgesia if NRS≥4. in the first 24 hours.
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