A comparative study of efficacy of Ropivacaine 0.25 percent versus Ropivacaine 0.375 percent with dexmedetomidine as adjuvant in ultrasound-guided erector spinae plane block for postoperative analgesia in laparoscopic cholecystectomy

Laparoscopic abdominal surgery offers numerous advantages including improved early postoperative ambulation and reduced surgical trauma leading to faster recovery and fewer complications compared with open surgery However despite these benefits patients frequently experience significant postoperative pain especially in the early recovery period which can hinder mobilization increase opioid consumption and contribute to chronic pain development Effective postoperative analgesia is therefore essential for patient comfort accelerated rehabilitation and minimization of opioidrelated adverse effects

Multimodal analgesia strategies incorporating nonopioid medications and regional nerve blocks have become standard for managing pain after laparoscopic procedures The ultrasoundguided erector spinae plane ESP block first described by Forero et al in 2016 is an interfascial plane block that provides both visceral and somatic analgesia by diffusion of local anesthetic into the paravertebral and epidural spaces Its simplicity under ultrasound guidance and favorable safety profile have led to rapid adoption in thoracic and abdominal surgeries Ropivacainea longacting amide local anestheticis preferred in regional techniques due to its lower cardiotoxicity and improved motorsensory separation The concentration of ropivacaine influences block quality duration and sideeffect profile however direct comparisons of different concentrations in ESP blocks for laparoscopic surgery remain scarce Dexmedetomidine a highly selective  adrenergic agonist is increasingly used as an adjuvant in regional anesthesia When added to local anesthetic low dose dexmedetomidine prolongs sensory block duration enhances analgesia and reduces    opioid  requirements without significant hemodynamic instability The aim of this study is to compare the efficacy of 025 versus 0375 ropivacaine each with a fixed dose of dexmedetomidine as adjuvant in ultrasoundguided Erector spinae plane block for postoperative analgesia in laparoscopic cholecystectomy