BACKGROUND To compare Quadratus Lumborum Block (QLB) and Transversus Abdominis Plane (TAP) blocks for postoperative pain control following laparoscopic cholecystectomy. Study and Design Prospective randomized head-to-head clinical trial. Methods A total of 60 patients who were set to undergo elective laparoscopic cholecystectomy were randomly separated into two groups. QLB was preoperatively applied to 30 patients and TAP block was also applied to 30 patients. A record was made of the intraoperative additional fentanyl dose, and at postoperative 0-1-2-4-6-12-24 hours, records were made of cumulative morphine consumption, number of morphine requests, VAS values, shoulder pain, heartrate, systolic and diastolic blood pressure, SpO2, sedation score (Ramsey scale), itching, nausea and vomiting, respiratory depression, and other complications. Results In the examination of intraoperative additional fentanyl use, there was no requirement for additional fentanyl in 86.7% of the QLB group, while in 60% of the TAP group, there was seen to be at least one dose of additional fentanyl required. At all timepoints between 0 and 24 hours postoperatively, the cumulative morphine requests and morphine consumption values were significantly lower in the QLB group than in the TAP group. No statistically significant difference was determined between the groups with respect to nausea, vomiting, sedation, and itching as morphine-related side effects. Conclusion Morphine consumption was significantly lower in patients who underwent QLB procedure at 6, 12, 24, and 48 hours compared to the TAP group. In general, effective analgesia was provided by both methods, but more effective analgesia was determined to have been provided in the QLB group compared to the TAP group, and thus QLB can be preferable to TAP.

BackgroundTo compare Quadratus Lumborum Block (QLB) and Transversus Abdominis Plane (TAP) blocks for postoperative pain control following laparoscopic cholecystectomy.Study and Design Prospective randomized head-to-head clinical trial. Methods A total of 60 patients who were set to undergo elective laparoscopic cholecystectomy were randomly separated into two groups. QLB was preoperatively applied to 30 patients and TAP block was also applied to 30 patients. A record was made of the intraoperative additional fentanyl dose, and at postoperative 0-1-2-4-6-12-24 hours, records were made of cumulative morphine consumption, number of morphine requests, VAS values, shoulder pain, heartrate, systolic and diastolic blood pressure, SpO2, sedation score (Ramsey scale), itching, nausea and vomiting, respiratory depression, and other complications.Results In the examination of intraoperative additional fentanyl use, there was no requirement for additional fentanyl in 86.7% of the QLB group, while in 60% of the TAP group, there was seen to be at least one dose of additional fentanyl required. At all timepoints between 0 and 24 hours postoperatively, the cumulative morphine requests and morphine consumption values were significantly lower in the QLB group than in the TAP group. No statistically significant difference was determined between the groups with respect to nausea, vomiting, sedation, and itching as morphine-related side effects.Conclusion Morphine consumption was significantly lower in patients who underwent QLB procedure at 6, 12, 24, and 48 hours compared to the TAP group. In general, effective analgesia was provided by both methods, but more effective analgesia was determined to have been provided in the QLB group compared to the TAP group, and thus QLB can be preferable to TAP.

Purpose : Rocuronium bromide is a painful agent while general anesthesia induction. The aim of the study is to investigate the effects of cox inhibitors as a resque agent against the rocuronium pain Methodology : Sixty patients enrolled for the general anesthesia enrolled in this study. Patients were allocated into two groups (Group 1: Dexkethoprofen group, Group 2: Control group) .Pain was evaluated by during rocuronium injection, patients were scored by a scale showed below. 0;No movement response to injection 1;Mild movement response to injection 2;Hand withdrawal response to injection 3;Arm withdrawal response to injection We also evaluated the pain with 2 questions when the patient was in the recovery room.Question 1.What was the last feeling before you fall into sleep? and question 2. Did you feel any pain on your hand during medication injection for anesthesia? Results:There were differences between the groups in terms of total pain score for example in group 1 there were 16 (53%) patients who did not make any movement during rocuronium injection while there were 22 (73%) patients in group 2.There was significant difference in injection rocuronium bromide pain between group 1: dexkethoprofen group, Group 2: control group in terms of the answer to the second question.Patients felt less pain than the control group. Conclusion:The effect of cox inhibitors on rocuronium pain was seen in our study but check is also effective in reducing pain in vascular width.

There is a lack of consensus on the combination doses of local anesthetics and opioids for spinal anesthesia in patients undergoing total knee arthroplasty (TKA) surgery. Opioids and local anesthetic combinations are associated with many postoperative side effects at high doses. We aimed to assess the use of the lowest possible doses of intrathecal bupivacaine and morphine for TKA.