Objectives: This randomized, single-blind study aimed to compare the effects of ultrasound-guided erector spinae plane block (ESPB), thoracic paravertebral block (TPVB) and intravenous (IV) analgesia on postoperative pain, opioid consumption and quality of recovery in patients undergoing laparoscopic cholecystectomy (LC). Methods: A total of 120 adult patients (ASA I-III) scheduled for elective LC were randomized into three groups: ESPB (GI), TPVB (GII) and IV analgesia (GIII). Bilateral ESPB or TPVB was performed preoperatively; then all patients received standardized general anesthesia and postoperative analgesia including paracetamol, tenoxicam and IV tramadol via patient-controlled analgesia. The primary outcome was 24 h tramadol consumption. Secondary outcomes included pain scores, rescue analgesia requirement, patient satisfaction, postoperative nausea and vomiting, time to first ambulation, length of hospital stay and Quality of Recovery-15 (QoR-15) scores. Results: Twenty-four-hour tramadol consumption was significantly higher in GIII (135.78 ± 22.73 mg) compared with GI (101.05 ± 26.99 mg) and GII (95.67 ± 31.49 mg) (p < 0.001), with no difference between GI and GII. Both static and dynamic pain scores were lower in GI and GII compared with GIII at most time points. Rescue analgesia requirement and patient dissatisfaction were significantly higher in GIII. QoR-15 scores were significantly improved in GI and GII compared with GIII (p < 0.001), while no difference was observed between the regional techniques. Block performance time was shorter with ESPB than TPVB (p < 0.001). No complications were reported. Conclusions: ESPB and TPVB provided effective analgesia and improved recovery after LC compared with IV analgesia alone. Both regional techniques may be considered as components of multimodal analgesia after LC.

Although perioperative oxygen therapy is a routine component of general anesthesia, its early biological consequences remain incompletely understood. This prospective randomized study evaluated whether perioperative oxygen concentration influences early biomarker responses in adults undergoing elective laparoscopic lower abdominal surgery. Patients received either normoxia (FiO₂ 0.35) or hyperoxia (FiO₂ 0.80) under standardized anesthesia. Clear physiological separation between groups was confirmed by arterial blood gas analysis. The primary biomarker finding was that circulating surfactant protein-A (SP-A) increased significantly in the normoxia group, whereas no comparable increase was observed under hyperoxia. Syndecan-1 and sialic acid showed descriptively similar directional patterns; however, these secondary biomarker findings were interpreted as exploratory and were not robust after Holm correction. By contrast, tumor necrosis factor-alpha (TNF-α) levels were higher postoperatively in the hyperoxia group, while ischemia-modified albumin (IMA) and total protein did not differ significantly between groups. These findings suggest that perioperative hyperoxia was associated with different early circulating biomarker trajectories across pulmonary epithelial and glycocalyx-related domains, without establishing pulmonary or endothelial protection. Further studies are needed to determine whether these early mechanistic findings translate into clinically meaningful outcomes.