This study is designed to compare three different methods of pain control after laparoscopic gallbladder surgery (laparoscopic cholecystectomy). Although this surgery is minimally invasive, participants often experience different types of pain after the operation, such as pain at the incision site, pain inside the abdomen, and shoulder pain caused by the gas used during surgery.
The investigators will compare three commonly used pain relief techniques:
Local infiltration - injecting a numbing medicine (bupivacaine) into the gallbladder bed and at the sites where the surgical instruments are placed.
Erector spinae plane (ESP) block - an ultrasound-guided nerve block performed in the back to reduce both abdominal and incisional pain.
Intrathecal morphine - a very small dose of morphine given into the spinal fluid before surgery to provide long-lasting pain relief.
The goal is to determine which method provides the best pain control, reduces the need for opioid medications, and improves recovery after surgery.
Adults aged 18-65 years
Scheduled for elective laparoscopic cholecystectomy
American Society of Anesthesiologists (ASA) physical status I-III
Able to provide written informed consent
Body mass index (BMI) > 35 kg/m²
History of coagulopathy or bleeding disorders
Known allergy or hypersensitivity to opioids or local anesthetics
Chronic pain or regular analgesic use