Interfascial Abdominal Wall Block for Gynecological Laparoskopy: A Randomized Clinical Trial

The purpose of this study is to evaluate the clinical efficacy of combining ultrasound-guided bilateral rectus sheath blocks (RSB) and quadratus lumborum blocks (QLB) compared to using a quadratus lumborum block alone for postoperative analgesia in patients undergoing laparoscopic gynecological surgeries. The primary objective is to assess movement-evoked pain scores in the early postoperative period. Secondary objectives include the evaluation of postoperative opioid consumption, intraoperative hemodynamic stability, and the overall incidence of side effects. Investigators hypothesize that the combined interfacial abdominal wall block technique will provide superior pain relief and reduce opioid requirements during recovery.

Inclusion Criteria: * Scheduled for elective gynecological video-laparoscopic surgery. * ASA physical status І-ІІ. * Age between 18 and 65 years. * Patient's informed consent to participate in the study Exclusion Criteria: * Known allergy or contraindications to local anesthetics. * Infection at the potential needle insertion sites. * Coagulopathy or ongoing anticoagulant therapy. * Conversion to open laparotomy during surgery. * Severe cognitive impairment or psychiatric disorders.