Background: Effective postoperative pain control after cesarean delivery is essential for facilitating early mobilization and reducing analgesic requirements. Ultrasound-guided fascial plane blocks, such as the transversus abdominis plane (TAP) and transversalis fascia plane (TFP) blocks, are increasingly used as components of multimodal analgesia; however, direct comparative data between these techniques remain limited. Methods: In this prospective observational study, 90 patients undergoing repeat cesarean deliveries under spinal anesthesia were administered either a bilateral ultrasound-guided transversus abdominis plane (TAP) block or a transversus fascia plane (TFP) block in accordance with standard clinical practice. The intensity of postoperative pain, assessed both at rest and during movement, was determined using VAS scores at 3, 6, 12, and 24 h after surgery. The time until first ambulation and additional postoperative analgesic consumption beyond the standardized baseline analgesic regimen over the first 24 postoperative hours were also evaluated. Results: The patients who were administered a TFP block had diminished postoperative pain levels, reduced additional postoperative analgesic requirements, and expedited mobilization relative to those administered a TAP block. The TFP group had considerably lower movement-related pain levels within the first 24 h following surgery. Opioid-related adverse effects were comparable between groups. Conclusions: After a repeat cesarean delivery, applying a TFP block was linked to better postoperative analgesia and fewer analgesic requirements than applying a TAP block. These findings suggest that TFP blocks may represent an effective component of multimodal analgesia in obstetric anesthesia.

Background/Objectives: Following total knee arthroplasty (TKA), adductor canal block (ACB) is usually used for postoperative analgesia; however, the optimal injection level is yet unclear. This study tried to determine how the injection level of the ACB had an impact on postoperative analgesic efficacy and functional results after total knee arthroplasty. Methods: A total of 108 patients undergoing unilateral total knee arthroplasty under spinal anesthesia were included in this prospective observational study and were categorized according to the level of ultrasound-guided adductor canal block performed (proximal [Group I], mid [Group II], or distal [Group III]). The visual analog scale (VAS) was used to measure postoperative pain at 1, 4, 8, 12, and 24 h. Additionally, functional pain throughout 24-h standardized static and dynamic tests was assessed. We noted 24-h opioid consumption, motor strength levels, and sensory and motor block features. Results: During each time point, the distal group’s VAS scores were considerably higher than those of the proximal and mid groups (e.g., 8th hour: 40.69 ± 10.50 vs. 26.94 ± 8.72 and 23.47 ± 7.64, p < 0.001), whereas there was no difference between the proximal and mid groups (p > 0.05). At 24 h, the distal group had significantly higher functional pain scores on all dynamic and static measures (p < 0.001). The proximal and mid groups had longer sensory block durations (5.38 ± 1.33 and 5.03 ± 1.29 h) than the distal group (2.95 ± 0.95 h, p < 0.001). While mid-level ACB maintained motor function, 13.9% of patients receiving proximal ACB experienced transient motor block. Conclusions: After TKA, injection level has a major impact on postoperative analgesia. Mid-level ACB supports the employment of multimodal analgesia techniques by offering the best possible compromise between efficient pain management and motor function maintenance.

Background/Objectives: Shortened clear-fluid fasting is increasingly supported in pediatric anesthesia, yet its combined effects on child-centered perioperative outcomes, family satisfaction, metabolic response, and gastric ultrasonography findings remain unclear. This study evaluated the associations of two routine preoperative fasting practices with preoperative anxiety, perioperative blood glucose, hemodynamic parameters, family satisfaction, and gastric ultrasonography findings in children undergoing elective surgery. Methods: This prospective, two-arm, observational cohort study included 66 children aged 3–12 years with American Society of Anesthesiologists (ASA) physical status I–II scheduled for elective adenotonsillectomy under general anesthesia, following either standard overnight fasting or 5 mL/kg carbohydrate-containing clear apple juice approximately 2 h before surgery. Preoperative anxiety was assessed using the Modified Yale Preoperative Anxiety Scale; blood glucose, hemodynamic parameters, gastric antral cross-sectional area, estimated gastric residual volume, Perlas classification, family satisfaction, fasting duration, and nausea and vomiting were also evaluated. Results: Preoperative anxiety scores were significantly lower in the clear-fluid group than in the overnight fasting group (39.95 ± 20.02 vs. 51.88 ± 22.05; p = 0.003). No significant differences were observed between groups in blood glucose, gastric antral cross-sectional area, estimated gastric residual volume, or Perlas scores. Family satisfaction was significantly higher in the clear-fluid group (8.76 ± 1.66 vs. 4.12 ± 2.00; p < 0.001), and fasting duration was markedly shorter. No perioperative pulmonary aspiration occurred. Conclusions: Administration of 5 mL/kg of carbohydrate-containing clear fluid approximately 2 h before surgery was associated with lower preoperative anxiety and higher family satisfaction, with no significant between-group difference in gastric residual volume.