M-TAPA vs ESPB for Postoperative Analgesia After Laparoscopic Cholecystectomy

Postoperative pain after laparoscopic cholecystectomy can negatively affect patient comfort, recovery, and opioid consumption. Regional abdominal wall blocks are commonly used as part of multimodal analgesia to improve postoperative pain control and reduce opioid-related side effects. The modified thoracoabdominal nerve block through the perichondrial approach (M-TAPA) and the erector spinae plane block (ESPB) are two ultrasound-guided regional anesthesia techniques that have been shown to provide effective postoperative analgesia in abdominal surgery. However, comparative clinical data between these two techniques in laparoscopic cholecystectomy are limited. This randomized, single-blind clinical trial aims to compare the postoperative analgesic effectiveness of M-TAPA and ESPB in adult patients undergoing elective laparoscopic cholecystectomy. Postoperative pain scores, opioid consumption, time to first analgesic requirement, and patient satisfaction will be evaluated.

Inclusion Criteria: * Adult patients aged 18-65 years * ASA physical status I-II * Scheduled for elective laparoscopic cholecystectomy under general anesthesia * Ability to understand the study procedures and provide written informed consent Exclusion Criteria: * Refusal to participate * Known allergy to local anesthetics * Coagulation disorders or anticoagulant therapy * Infection at the injection site * Severe hepatic, renal, or cardiac disease * Chronic opioid use