This study aims to evaluate the effects of ultrasound-guided interscalene, erector spinae plane, costoclavicular, and supraclavicular blocks on hemidiaphragmatic paralysis, postoperative recovery quality, opioid consumption, and pain scores.

Arthroscopic shoulder surgery is a significant approach to diagnosing and treating rotator cuff tears, impingement syndrome, instability, SLAP and Bankart injuries, and other shoulder disorders. Applications of this technique have become increasingly popular in recent yeras. Howeveri although arthroscopic sholuder surgery is conderered minimally invasive, it has been reported to cause moderate to severe postoperative pain, which can hinder patient recovery and rehabilitation, and potentially even extend the hospital stay. Therefore, providing an effective postoperative analgesia strategy in these patients is critical for patient comfort, mobilization, and overall recovery. Various methods are employed to managepostoperative pain in patients undergoing arthroscopic shoulder surgery, with regional techniques being the most prevalent. These regional techniques provide both intraoperative and postoperative analgesia in shoulder surgeries. The aim of this study is to evaluate the effects of ultrasound-guided four block techniques on hemidiaphragmatic paralysis, postoperative recovery quality, opioid consumption, and pain scores.

Inclusion Criteria:

• aged 18-65 years
• American Society of Anaesthesiology (ASA) score I-III
• body mass index (BMI) <30kg/m2
• scheduled for elective arthroscopic surgery

Exclusion Criteria:

• ASA score ≥4
• BMI ≥30 kg/m2
• declining to give written informed consent
• controendications for block application
• history of mental or neurological disease, severe liver and/or kidney disease
• history of moderate or severe pulmonary disease
• abnormal preoperative chest X-ray findings
• scheduled for emergency surgery

It is planned to include ASA score I-III, aged 18-65 years, who are planned to undergo elective arthroscopic surgery