Perioperative Opioid-sparing Effect of Retrosuperior Costotransverse Ligament Block Versus Erector Spinae Block in Laparoscopic Cholecystectomy

Perioperative Opioid-sparing Effect of Retrosuperior Costotransverse Ligament Block Versus Erector Spinae Block in Laparoscopic Cholecystectomy: A Randomized Clinical Trial.

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

This study aims to compare between retro superior costotransverse ligament space block vs erector spinae plane block

• To compare the analgesic outcomes (time to first analgesic request, total amount of analgesic consumption and pain scores by NRS)
• To assess the block performance time required to perform each technique .
• To compare intraoperative parameters (hemodynamics and intraoperative fentanyl consumption)
• To assess patient, surgeon satisfaction and complications of the block.

Inclusion Criteria:

1. patient acceptance
2. Age: 21-64 years old.
3. Sex: both sexes.
4. Physical status: ASA I & II.
5. Body mass index (BMI): 18.5 - 30 kg/m2.
6. Type of operations: elective laparoscopic cholecystectomy.
7. Duration of surgery not more than 2 hours.

Exclusion Criteria:

1. Known hypersensitivity to lidocaine or bupivacaine.
2. Patients with respiratory insufficiency.
3. Coagulation disorders or taking drugs affect surgical hemostasis.

7. Patients with pre-existing neurological deficits. 8. Uncooperative patient or with altered mental status. 9. Patient with advanced cardiovascular or respiratory diseases