Ultrasound-Guided Rectus Sheath Block Versus Local Infiltration

Condition(s) studied

Investigational drug(s) / intervention(s)

Rectus Sheath Block: After completion of the operation, during the surgical closure phase, bilateral rectus sheath block will be performed. A linear ultrasound probe will be placed transversely over the umbilicus and 1 cm lateral to it. After visualization of the rectus abdominis muscle and posterior rectus sheath, a 22-Gauge 80 mm block needle (Braun Stimuplex Ultra-360, Melsungen, Germany) will be advanced from lateral to medial using the in-plane technique. Following hydrodissection with 1 mL saline between the rectus muscle and posterior sheath and confirmation of appropriate spread, 20 mL local anesthetic (0.25% bupivacaine) will be administered with intermittent negative aspiration.

Local Anesthetic Infiltration: At the end of the operation, the surgeon will infiltrate 5 mL local anesthetic (0.5% bupivacaine) subcutaneously into each of the four trocar insertion sites.

Study summary

Laparoscopic cholecystectomy is associated with significant postoperative pain originating from trocar sites, pneumoperitoneum, and visceral irritation. Both local anesthetic infiltration and ultrasound-guided rectus sheath block are commonly used regional analgesic techniques to reduce postoperative pain and opioid consumption. This prospective randomized controlled study aims to compare the effects of these two techniques on postoperative pain scores, opioid requirements, and analgesia-related adverse effects following laparoscopic cholecystectomy.

Eligibility

Primary outcome measure(s)

• NRS Score — Pain scores will be assessed and recorded at postoperative 0, 1, 4, 12, and 24 hours.
  Postoperative pain assessment will be performed using the Numeric Rating Scale (NRS). The NRS is a scale in which patients rate their pain intensity numerically from 0 (no pain) to 10 (worst imaginable pain).

Trial sites (1)

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