Clinical Research Directory

Heat Application and Shoulder Pillow for Post-Laparoscopic Shoulder Pain

The goal of this clinical trial is to learn whether heat application combined with a shoulder support pillow reduces shoulder pain in adults (18 years and older) who undergo elective laparoscopic cholecystectomy and develop shoulder pain within the first 2 hours after surgery. The main questions it aims to answer are: Does heat application with a shoulder support pillow reduce postoperative shoulder pain scores during the first 24 hours after surgery? Does it reduce incision pain and the amount of analgesics used within 24 hours after surgery? Researchers will compare patients receiving heat application and a shoulder support pillow with patients receiving routine postoperative care only, to see if the intervention lowers shoulder pain, incision pain and analgesic consumption. Participants will be randomly assigned to the intervention group or the control group. Participants in the intervention group will: Receive heat application with a towel-wrapped thermal gel pack (maximum 40°C) to the right trapezius and upper scapular region for 20 minutes at postoperative hours 2, 4, 6 and 8 Use a fiber-filled shoulder support pillow under the right shoulder and arm for 24 hours after surgery, except during mobilization Participants in the control group will: Receive no study intervention and will receive routine postoperative care only All participants in both groups will: Rate their shoulder pain and incision pain on a 0-10 Numerical Rating Scale at postoperative hours 1, 3, 5, 7, 9, 11, 20 and 24 Have their analgesic use during the first 24 hours after surgery recorded

Effects of Bolus Versus Infusion Ketamine During Laparoscopic Cholecystectomy

This prospective, randomized, controlled study evaluated the effects of different ketamine administration strategies in adult patients undergoing elective laparoscopic cholecystectomy under general anesthesia. Participants were randomized into three groups: bolus ketamine, continuous ketamine infusion, or control without ketamine. The study investigated the effects of these strategies on optic nerve sheath diameter measured by ultrasonography as a surrogate marker of intracranial pressure, intraoperative sevoflurane consumption, and postoperative pain and analgesic requirements.

Adding Magnesium Sulfate or Dexmedetomidine to Bupivacaine in Oblique Subcostal Tap Block for Laparoscopic Cholecystectomy: A Randomized Double -Blind Controlled Study

Laparoscopic cholecystectomy (LC) is one of the commonly performed surgical procedures associated with a moderate degree of postoperative pain especially on the 1st postoperative day. Adequate postoperative analgesia allows early patient ambulation, decreases analgesic requirements, and hospital stay. Moreover, it has been hypothesized that intense acute pain after LC may predict development of chronic pain (e.g., post laparoscopic cholecystectomy syndrome). So, aggressive perioperative analgesia is needed. the aim of the study is To compare the analgesic effect of magnesium sulfate combined with bupivacaine versus bupivacaine combined dexmedetomidine via OSCTAB block on postoperative pain control for 24 hours in patients scheduled for LC.

Analgesic Efficacy of Adding Dexmedetomidine to Erector Spinae Plane Block Versus Subcostal Transverse Abdominis Plane Block in Laparoscopic Cholecystectomy

Our scientific work aimed to evaluate the analgesic efficacy of dexmedetomidine as an adjuvant to erector spinae plane block versus subcostal transverse abdominis plane block in patients undergoing laparoscopic cholecystectomy.

Binaural Beats and Postoperative Nausea and Vomiting in Laparoscopic Cholecystectomy

This research is a single-center, parallel-group, single-blind, randomized controlled experimental study planned to evaluate the effect of postoperative binaural beats (BB) application on the incidence of postoperative nausea and vomiting (PONV) and the need for antiemetics in patients undergoing elective laparoscopic cholecystectomy. The research will be conducted in two phases. In the first phase, 30-minute binaural beats audio recordings containing alpha (10 Hz) and theta (6 Hz) frequencies will be developed to ensure standardization. In the second phase, the effect of the developed sound recordings on postoperative nausea and vomiting will be evaluated. The research will be conducted in the General Surgery Department of Kütahya City Hospital between January and September 2027. A total of 76 patients who meet the inclusion criteria for the study are planned to be randomized into intervention (n=38) and control (n=38) groups in a 1:1 ratio. Patients in the intervention group will listen to a binaural beats audio recording at approximately 60 dB sound level for 30 minutes through stereo headphones, starting 2 hours after being admitted to the surgical ward. In the control group, patients will listen to a placebo sound recording with similar acoustic properties but without binaural beats for the same duration and under the same environmental conditions. Both groups will receive standard postoperative care. The primary outcome measure of the study is the incidence of postoperative nausea and vomiting. The secondary outcome measures are the total score of the Postoperative Nausea and Vomiting Impact Scale, the clinically significant postoperative nausea and vomiting incidence rate, and the need for rescue antiemetics. Nausea-vomiting assessments will be conducted at postoperative 2nd, 6th, and 24th hours; the use of antiemetic drugs will be obtained from patient records. The obtained data will be analyzed using appropriate statistical methods and compared between groups.

Subcostal TAP Block Versus Combined Subcostal TAP and Recto-Intercostal Fascial Plane Block for Analgesia After Laparoscopic Cholecystectomy

Laparoscopic cholecystectomy is commonly associated with moderate postoperative pain, particularly during the early postoperative period. Inadequate postoperative analgesia may negatively affect patient comfort and recovery, increase opioid consumption, and contribute to opioid-related adverse effects. Therefore, effective multimodal analgesic strategies are of considerable importance in patients undergoing laparoscopic cholecystectomy. Subcostal transversus abdominis plane (TAP) block is a regional anesthesia technique used to provide analgesia for upper abdominal surgery. However, its analgesic coverage may be insufficient in some patients because of the complex innervation of the upper abdominal wall. The recto-intercostal fascial plane block has been described as a fascial plane block targeting the anterior branches of the thoracoabdominal nerves and may provide additional analgesic benefit when combined with subcostal TAP block. This study aims to compare the postoperative analgesic efficacy of bilateral subcostal TAP block alone with that of bilateral subcostal TAP block combined with recto-intercostal fascial plane block in patients undergoing elective laparoscopic cholecystectomy.

Effects of Intraoperative Warming Methods on Hematologic Inflammatory Indices in Laparoscopic Cholecystectomy

Perioperative hypothermia is a frequent and preventable complication that may cause adverse outcomes such as increased blood loss, impaired coagulation, and delayed recovery. Various active warming techniques are used to maintain normothermia during anesthesia; however, their comparative effects on systemic inflammatory responses remain unclear. This randomized controlled clinical trial aims to evaluate the effects of different intraoperative warming methods on hematologic inflammatory indices - including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) - in patients undergoing elective laparoscopic cholecystectomy under general anesthesia. A total of eligible adult patients will be randomly assigned into four groups according to the intraoperative warming method applied: Control Group: No active warming applied. Forced-Air Warming (FAW) Group: Warming blanket system used throughout surgery. Fluid Warming (FW) Group: Intravenous fluids warmed to maintain normothermia. Combined Warming (FAW + FW) Group: Both forced-air and fluid warming applied simultaneously. Core body temperature and perioperative data will be recorded. Venous blood samples will be obtained preoperatively and 24 hours postoperatively to calculate inflammatory indices. The primary objective is to determine whether active intraoperative warming techniques modulate postoperative inflammatory markers compared to no warming. Secondary outcomes include intraoperative temperature trends, recovery times, and the incidence of hypothermia-related complications. The results are expected to identify the most effective warming strategy to minimize inflammation and optimize postoperative recovery in laparoscopic procedures.

The Effect of White Noise on Sleep, Quality of Recovery, and Satisfaction in Patients Undergoing Laparoscopic Cholecystectomy

This randomized controlled trial aims to evaluate the effect of white noise on sleep, recovery quality, and satisfaction in patients undergoing laparoscopic cholecystectomy. In the postoperative period, patients encounter numerous physical and psychological stressors, such as pain, difficulty adapting to the hospital environment, immobilization, environmental noise, frequent nursing interventions, individual characteristics, and illness-related anxieties. These factors disrupt sleep patterns; a decline in sleep quality can negatively affect tissue healing, immune function, pain control, psychological well-being, and the overall recovery process. Consequently, patient satisfaction with the care process may also decrease. Although pharmacological methods are commonly used to manage postoperative insomnia, they are not always sufficiently effective and carry various limitations, such as sedation, drug interactions, and other adverse effects. Therefore, interest has grown in recent years regarding non-pharmacological interventions that are safe, cost-effective, easy to implement, and carry a low risk of side effects. White noise, one such intervention, can create a more favorable sleep environment by masking irregular environmental sounds, promote relaxation, and has the potential to improve sleep quality.

The Effect of Guided Imagery in Laparoscopic Cholecystectomy

This clinical trial examines the effects of guided imagery in adults recovering from laparoscopic gallbladder surgery. The study focuses on pain levels, vital signs, and the quality of recovery after surgery. The study addresses the following questions: * Do participants who receive guided imagery experience different levels of pain after surgery? * Do participants' vital signs change after guided imagery? * Does the quality of recovery differ between participants who receive guided imagery and those who do not? Participants are followed in two groups. One group receives an 18-minute guided imagery session in addition to standard care, while the other group receives standard care only. The results from the two groups are compared to assess the possible effects of guided imagery. During the study, participants' pain levels and vital signs are measured at planned time points. Their quality of recovery after surgery is also assessed.

Humor-Based Video Intervention on Preoperative Anxiety Veya Humor Video and Recovery in Cholecystectomy

This study aims to evaluate whether watching a short humor-based video before surgery can reduce anxiety and negative emotions and increase positive emotions in patients undergoing elective laparoscopic cholecystectomy (gallbladder removal surgery). The study will also examine whether this intervention affects patients' quality of recovery after surgery. Patients scheduled for elective laparoscopic cholecystectomy will be randomly assigned to either a humor-based video intervention group or a control group. In addition to routine preoperative care and education, patients in the intervention group will watch an approximately 20-minute humor-based video before surgery. Patients in the control group will receive routine preoperative care and education without the humor-based video. Anxiety, positive and negative emotions, and postoperative quality of recovery will be assessed using standardized questionnaires. The study will compare these outcomes between the two groups to determine whether the humor-based video provides beneficial effects during the perioperative period.

Effect of Preoperative Melatonin on Quality of Recovery After Elective Laparoscopic Cholecystectomy

Laparoscopic cholecystectomy is one of the most commonly performed abdominal surgical procedures worldwide. Although the widespread implementation of Enhanced Recovery after Surgery (ERAS) protocols has improved perioperative outcomes, many patients continue to experience postoperative pain, sleep disturbance, anxiety, nausea, and fatigue, symptoms that collectively impair overall quality of recovery (QoR). Melatonin, an endogenous hormone that regulates circadian rhythm, also possesses anxiolytic, analgesic, antioxidant, and anti-inflammatory properties, positioning it as a valuable perioperative adjunct. However, most previous studies have evaluated melatonin primarily for isolated outcomes such as sleep quality or anxiety. Its effect on comprehensive postoperative recovery, assessed using validated patient-reported outcome instruments, remains insufficiently explored, particularly in laparoscopic cholecystectomy populations and in South Asian clinical settings. This prospective, randomized, double-blind, placebo-controlled trial (the MEL-REC trial) aims to evaluate the effect of preoperative oral melatonin on postoperative quality of recovery in patients undergoing elective laparoscopic cholecystectomy under general anaesthesia. The study will be conducted in the Department of Anaesthesiology at Combined Military Hospital (CMH), Dhaka, Bangladesh, over a total study period of 18 months (January 2026 to June 2027), with patient recruitment planned for 8 months (May to December 2026) after taking approval from institutional review board. Eighty four adult patients aged 18-60 years with American Society of Anesthesiologists (ASA) physical status I-II will be randomly allocated in a 1:1 ratio into two equal groups (n = 42 per group) using computer-generated permuted block randomization with centralized pharmacy based allocation concealment. The melatonin group (Group M) will receive oral melatonin 6 mg administered 60 minutes before induction of anaesthesia and the placebo group (Group P) will receive an identical placebo tablet under the same conditions. Neither the participants, the treating anaesthesiologist, the outcome assessor, nor the data analyst will be aware of group allocation until database lock. All patients will receive a standardized anaesthesia and perioperative management protocol, including standardized postoperative analgesia. The primary outcome will be postoperative quality of recovery assessed using the Quality of Recovery-15 (QoR-15) score at 24 ± 2 hours after surgery. Secondary outcomes include postoperative sleep quality measured by the Richards-Campbell Sleep Questionnaire, change in preoperative anxiety (delta-VAS-A score), total opioid consumption during the first 24 hours expressed as intravenous morphine milligram equivalents, incidence of postoperative nausea and vomiting, and time to first rescue analgesic request. All postoperative outcomes will be assessed by a trained research assistant blinded to group allocation. Based on the available evidence, it is anticipated that patients receiving preoperative melatonin will demonstrate higher QoR-15 scores at 24 hours after surgery compared with the placebo group. The melatonin group is also expected to have improved postoperative sleep quality, reduced opioid consumption, and a greater reduction in preoperative anxiety. If a clinically meaningful benefit is confirmed, given its well established safety profile, low cost, and ease of oral administration, preoperative melatonin may represent a practical perioperative adjunct that can be readily incorporated into ERAS protocols for laparoscopic cholecystectomy. The trial will be prospectively registered in the Bangladesh Medical Research Council (BMRC) clinical trial registry or clinicaltrials.gov prior to recruitment.

RIPB Versus EOIPB for Pain Control After Laparoscopic Cholecystectomy

This prospective observational study aims to compare the effects of bilateral ultrasound-guided recto-intercostal plane block(RIPB) and bilateral ultrasound-guided external oblique intercostal plane block(EOIPB) on postoperative analgesia in patients undergoing elective laparoscopic cholecystectomy under general anesthesia. Both blocks are performed after anesthesia induction as part of routine preemptive multimodal analgesia practice. Patients who receive bilateral recto-intercostal plane block will be included in the RIPB group, and patients who receive bilateral external oblique intercostal plane block will be included in the EOIPB group. The primary outcome is cumulative intravenous tramadol consumption via patient-controlled analgesia during the first 24 postoperative hours. Secondary outcomes include postoperative pain scores at rest and during activity, rescue analgesic requirement, postoperative nausea and vomiting, time to mobilization, length of hospital stay, quality of recovery assessed using the Quality of Recovery-15 questionnaire, and block-related complications.

Superficial Plane Blocks for Analgesia After Laparoscopic Cholecystectomy

This prospective, single-center observational study will evaluate postoperative analgesia in adults undergoing elective laparoscopic cholecystectomy. Participants will receive routine anesthetic care selected by the responsible anesthesiologist and will be observed in one of three groups: rectointercostal plane block, external oblique-rectus abdominis plane (EXORA) block, or intravenous patient-controlled analgesia (IV PCA). The study will compare postoperative pain scores and sensory block spread. Pain at rest and with movement will be assessed using the 0-to-10 Numeric Rating Scale at 0, 2, 4, 6, 12, and 24 hours after surgery. Sensory spread will be assessed by pinprick testing across the T4-T12 dermatomes at 30 minutes after surgery. Additional assessments will include 24-hour tramadol consumption, postoperative nausea and vomiting, and block-related complications.

ESP vs. EXORA Blocks for Analgesia in Laparoscopic Cholecystectomy

Patients undergoing laparoscopic cholecystectomy may experience moderate to severe postoperative pain. Effective postoperative analgesia enhances patient comfort and accelerates recovery. This study aims to compare the effects of Erector Spinae Plane (ESP) and External Oblique and Rectus Abdominis Plane (EXORA) blocks on postoperative pain management and analgesic consumption. The study is designed as a prospective, randomized, double-blind trial. Patients will be randomly assigned to groups, and both practitioners and evaluators will be blinded to group assignments. Our hypothesis is that the EXORA block will provide superior analgesia and require less analgesic consumption compared to the ESP block. The results will be assessed in terms of postoperative pain management, patient comfort, and additional analgesic requirements.

AI and Safety in Laparoscopic Cholecystectomy: A Randomized Controlled Trial

Today, the majority of gallbladder removals surgeries are done using minimally invasive techniques through small cuts to help patients recover faster. However, these procedures are technically more challenging because surgeons have a restricted view of the patient's anatomy, which can increase the risk of serious complications. Artificial intelligence (AI) tools have been developed to guide surgeons during surgery and help them make safer decisions that reduce the risk of injury to the patient. This study will use a randomized controlled trial to compare outcomes between surgeries with AI assistance and standard procedures without AI. Primary Objective: To determine whether the AI improves surgeons' ability to achieve the Critical View of Safety, a key step for safe gallbladder removal, compared to standard procedures. Secondary Objectives: * Determine whether the AI helps the surgeon perform more safe dissections compared to the standard procedures. * Collect surgeon feedback on the use of AI during the procedure

Subcostal TAP Block and EEG Dynamics in Laparoscopic Cholecystectomy

Laparoscopic cholecystectomy is a commonly performed minimally invasive surgical procedure. Despite its minimally invasive nature, surgical stimulation and pneumoperitoneum may cause pain-related physiological and neurophysiological responses during general anesthesia. This prospective observational study will evaluate patients undergoing laparoscopic cholecystectomy under general anesthesia. Patients will be observed according to the analgesic technique selected by the attending anesthesiologist as part of routine clinical care: intravenous remifentanil alone or remifentanil combined with an ultrasound-guided subcostal transversus abdominis plane (TAP) block. The study will examine the relationship between the use of subcostal TAP block and intraoperative analgesic requirements, Bispectral Index (BIS) values, electroencephalographic (EEG) dynamics, and burst suppression. Postoperative pain scores, additional analgesic requirements, quality of recovery, mobilization time, length of hospital stay, and patient satisfaction will also be evaluated.

Esketamine Combined With Magnesium Sulfate for Postoperative Fatigue Syndrome in Patients Undergoing Laparoscopic Cholecystectomy

Laparoscopic cholecystectomy (LC), although minimally invasive, is frequently associated with postoperative fatigue syndrome (POFS), which can delay recovery and prolong convalescence. Esketamine, an NMDA receptor antagonist, has demonstrated potential benefits in reducing postoperative fatigue and pain through central sensitization blockade and anti-inflammatory effects. Magnesium sulfate, another NMDA receptor antagonist and physiological calcium channel blocker, offers complementary analgesic, anti-inflammatory, and cardiovascular-modulating properties. This randomized, double-blind, 2 × 2 factorial trial aims to evaluate the independent and combined effects of perioperative esketamine and magnesium sulfate on postoperative fatigue, recovery quality, pain, and intraoperative hemodynamics in patients undergoing LC, with the goal of identifying an effective and safe strategy to accelerate early postoperative rehabilitation.

Comparison of ANI Between Preoperative and Postoperative Ultrasound-guided TAP Block in Laparoscopic Cholecystectomy

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.

ERAS (Enhanced Recovery After Surgery) and Multimodal Analgesia in Laparoscopic Cholecystectomy

This clinical study aims to evaluate the effects of multimodal analgesia management administered within an ERAS (Enhanced Recovery After Surgery) protocol on postoperative pain, length of hospital stay, early complications, and additional opioid requirements in patients undergoing laparoscopic cholecystectomy. The key questions addressed are: * Does ERAS-based multimodal analgesia reduce postoperative pain? * Does it shorten the hospital stay and lower early complication rates? * What is its potential to reduce the need for additional opioids? Participants: * Prospective Group: Patients managed with an ERAS multimodal analgesia protocol (including paracetamol, NSAIDs (Non-Steroidal Anti-Inflammatory Drugs), and local wound infiltration analgesics) between April and July 2025. * Retrospective Group: Patient records from 2024 who were treated with a routine analgesia protocol. BThe study was planned with the actual number of patients who met the selection criteria within the predefined time frames. Consequently, a total of 63 patients were analyzed, with 30 patients in the prospective ERAS group and 33 patients in the retrospective control group.

Low-Flow Sevoflurane and Desflurane Anesthesia in Laparoscopic Cholecystectomy

Several studies have demonstrated that inhalational anesthetic agents such as desflurane and sevoflurane may cause varying degrees of postoperative sore throat, hoarseness, and cough in orotracheally intubated patients. However, data evaluating these outcomes under low-flow anesthesia conditions remain limited and insufficient. This single-center, prospective, randomized controlled study will be conducted in patients aged 18-65 years, classified as American Society of Anesthesiologists (ASA) physical status I-II, who are scheduled to undergo elective laparoscopic cholecystectomy under general anesthesia and who provide written informed consent to participate in the study. The primary objective of the study is to compare the effects of low-flow desflurane and low-flow sevoflurane anesthesia on the incidence and severity of postoperative sore throat. The secondary outcomes include the evaluation of postoperative hoarseness and cough, the incidence of postoperative nausea and vomiting (PONV), and the total consumption of inhalational anesthetic agents.

Effects of Foot Reflexology on Postoperative Pain, Anxiety, Nausea, and Vomiting Among Patients After Laparoscopic Cholecystectomy

This study aims to evaluate the effect of foot reflexology on pain, anxiety, nausea, and vomiting among patients after laparoscopic cholecystectomy. Participants will receive foot reflexology in addition to routine postoperative care, and outcomes will be assessed using appropriate measures before and after the intervention.

ANI-Guided Anesthetic Desflurane Consumption

General anesthesia requires precise titration of inhaled anesthetics like desflurane and opioids like remifentanil to balance sedation, analgesia, and hemodynamic stability. The Analgesia/Nociception Index (ANI), derived from heart rate variability (HRV), quantifies parasympathetic tone to assess nociception-antinociception balance on a 0-100 scale, with lower values indicating nociceptive stress. ANI analyzes high-frequency HRV components, reflecting parasympathetic inhibition during painful stimuli, making it a reliable indicator of intraoperative nociception. Studies validate the utility of ANI in detecting nociceptive events during laparoscopic surgery. ANI-guided opioid titration reduces opioid consumption and stabilizes hemodynamics, enhancing perioperative outcomes.

Ultrasound-Guided Regional Blocks for Postoperative Analgesia After Laparoscopic Cholecystectomy

Ultrasound (US)-guided recto-intercostal fascial plane block (RIFPB) is a recently described abdominal wall block performed by injecting local anesthetic between the rectus abdominis muscle and the costal cartilage of the 7th rib. Due to the cranial attachment of the rectus muscle, this technique provides effective analgesia to the sternal, epigastric, and upper-mid abdominal regions, corresponding to the T6-T10/11 dermatomal levels. RIFPB may be used as an adjunct technique for thoracic procedures or as a standalone block for abdominal surgery. Ultrasound-guided transversus abdominis plane block (TAPB) is performed by injecting local anesthetic into the fascial plane between the internal oblique and transversus abdominis muscles. TAPB provides sensory blockade of the anterolateral abdominal wall at the T6-L1 dermatomal levels and is widely used for postoperative analgesia following abdominal surgeries, including laparoscopic cholecystectomy. This study aims to compare the effectiveness of US-guided RIFPB and TAPB on postoperative pain control after laparoscopic cholecystectomy.

Comparison of Ultrasound-Guided Erector Spinae Plane Block and Modified Thoracoabdominal Nerve Block Through Perichondrial Approach (M-TAPA) for Postoperative Analgesia After Laparoscopic Cholecystectomy: A Randomized Controlled Study

This study compared two ultrasound-guided regional anesthesia techniques for pain relief after laparoscopic gallbladder surgery: the modified thoracoabdominal nerve block through a perichondrial approach and the erector spinae plane block. Adults undergoing elective laparoscopic cholecystectomy under general anesthesia were randomly assigned to receive one of these two nerve blocks on both sides of the body before awakening from anesthesia. Both techniques used bupivacaine as the local anesthetic. After surgery, pain intensity, tramadol consumption, need for additional pain medication, nausea and vomiting, antiemetic use, and block-related complications were assessed during the first 24 postoperative hours. The main objective was to determine whether the two techniques differed in their ability to reduce postoperative tramadol consumption and provide effective pain relief.