Background: Different regional anesthesia (RA) techniques have been used for laparoscopic cholecystectomy (LC), but there is no consensus on their comparative effectiveness. Our objective was to evaluate the effect of RA techniques on patients undergoing LC using a network meta-analysis approach.Methods: We conducted a systematic review and network meta-analysis. We searched PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and Web of Science (Science and Social Science Citation Index) using the following PICOS criteria: (P) adult patients undergoing LC; (I) any RA single-shot technique with injection of local anesthetics; (C) placebo or no intervention; (O) postoperative opioid consumption expressed as morphine milligram equivalents (MME), rest pain at 12 h and 24 h post-operation, postoperative nausea and vomiting (PONV), length of stay; and (S) randomized controlled trials.Results: A total of 84 studies were included. With the exception of the rectus sheath block (P = 0.301), the RA techniques were superior to placebo at reducing opioid consumption. Regarding postoperative pain, the transversus abdominis plane (TAP) block (−1.80 on an 11-point pain scale) and erector spinae plane (ESP) block (−1.33 on an 11-point pain scale) were the most effective at 12 and 24 h. The TAP block was also associated with the greatest reduction in PONV.Conclusions: RA techniques are effective at reducing intraoperative opioid use, postoperative pain, and PONV in patients undergoing LC. Patients benefit the most from the bilateral paravertebral, ESP, quadratus lumborum, and TAP blocks.

Background: Total Knee Arthroplasty (TKA) is one of the most commonly performed orthopedic procedures, and patients complain of severe pain in the postoperative period. The supra-inguinal fascia iliaca block (SIFIB) works as an anteriorly applied lumbar plexus block and is frequently used in hip surgeries. In this study, we evaluated the effect of SIFIB in patients undergoing TKA under spinal anesthesia. Methods: This study is a prospective, randomized, assessor-blinded feasibility study conducted in a tertiary hospital. Eighty-six patients with ASA I-III were initially enrolled, and after exclusions, 80 patients were randomized into two equal groups (SIFIB and control groups). The standard multimodal analgesia was applied to the control group, while SIFIB was additionally applied to the block group. The study measured the morphine requirement in PCA and pain intensity using Numeric Rating Scores between the two groups. Results: the 24-h cumulative morphine consumption was lower in Group SIFIB. Although there was a decrease in NRS at rest scores in the SIFIB group during some time periods, pain was moderate, and no differences in pain scores were recorded during exercise in all patients. Conclusions: In patients undergoing TKA under spinal anesthesia, a single shot of SIFIB results in a significant reduction in the amount of morphine consumed in hours. This effect was most likely related to a decrease in pain at rest in the SIFIF group.

Aim: Management of postoperative pain in hip surgeries is important for the quality of recovery. When regional anesthesia techniques are added to the multimodal analgesia plan, they increase the effectiveness of the analgesia plan. Supra-inguinal fascia iliaca block (SIFIB) is a technique that has been reported to be effective in hip surgery but requires the use of high-volume local anesthetics. Our aim in this retrospective study is to investigate the efficacy of local anesthetic in SIFIB when administered at a concentration lower than the conventional concentration.Material and Methods: The files of the patients who underwent hip hemiarthroplasty were planned to be evaluated retrospectively. Patients were grouped according to the bupivacaine concentration used in SIFIB (0.25% vs. 0.20%) and statistically evaluated in terms of morphine requirement, pain scores, and time to first analgesic.Results: There was no significant difference between the groups in terms of NRS score and cumulative morphine consumption at the 3rd, 6th, 12th, 18th, and 24th hours (p>0.05). When compared the first analgesia requirement times, there was no significant difference between Groups (p>0.05).Conclusion: A single shot SIFIB administered at a concentration of 0.20% also has analgesic properties, as do the conventional concentration of SIFIB containing 0.25% bupivacaine.