Comparison of the effects of erector spinae plane and transversus abdominis plane blocks on postoperative pain in obesity surgery ESP vs TAP for Postoperative Pain in Bariatric Surgery

Comparison of the effects of erector spinae plane and transversus abdominis plane blocks on postoperative pain in obesity surgery ESP vs TAP for Postoperative Pain in Bariatric Surgery | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Comparison of the effects of erector spinae plane and transversus abdominis plane blocks on postoperative pain in obesity surgery ESP vs TAP for Postoperative Pain in Bariatric Surgery Ergun GUNDUZ, Mehmet SARI This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7113354/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Backgroundː Obesity is a major global health concern, and bariatric surgery is a widely used treatment. Postoperative pain management in these patients is challenging due to comorbidities limiting opioid use. Regional anesthesia techniques such as the transversus abdominis plane (TAP) block and erector spinae plane (ESP) block are key components of multimodal analgesia. The TAP block targets the abdominal wall but may offer limited visceral pain relief. The ESP block, a newer method, allows for broader analgesia and may be easier to administer in obese patients. This study compared the postoperative analgesic efficacy and feasibility of TAP and ESP blocks in laparoscopic bariatric surgery. Methodsː In this retrospective review, 64 adult patients (ASA III, BMI 40–60 kg/m²) who underwent elective laparoscopic sleeve gastrectomy received either a TAP block (n=30) or an ESP block (n=34). Data on demographics, pain scores (VAS), time to first analgesic requirement, patient satisfaction, and adverse events were collected. The primary outcome was the mean VAS score within 24 hours postoperatively. Resultsː Baseline characteristics were similar. Both techniques were safe and well tolerated. The ESP group had significantly lower VAS scores at the 2nd postoperative hour (p=0.028), but differences diminished thereafter. Patient satisfaction was high in both groups (96.9%). Conclusionsː TAP and ESP blocks both provided effective, opioid-sparing analgesia with minimal complications. The ESP block may offer procedural advantages in obese patients. The choice between techniques can be guided by patient-specific factors and practitioner expertise. Further prospective studies are needed to explore long-term outcomes. Obesity Bariatric Surgery Pain Erector Spinae Plane Block Transversus Abdominis Plane Block Introduction Obesity is a major global health problem that continues to increase in prevalence [ 1 ]. Bariatric surgery is currently one of the most effective methods for achieving long-term weight loss in patients with severe obesity [ 2 ]. However, managing postoperative pain in these patients remains a significant challenge. Poor pain control can delay recovery, reduce mobility, impair respiratory function, and increase the risk of complications [ 3 ]. Effective pain management is especially important in this population due to common comorbidities such as obstructive sleep apnea, which limit the use of opioids. For this reason, regional anesthesia techniques have become an essential part of multimodal analgesia in bariatric surgery [ 4 ]. Among these, the transversus abdominis plane (TAP) block and the erector spinae plane (ESP) block are widely used. both techniques are performed under ultrasound guidance and aim to reduce pain and the need for opioids after surgery [ 5 ]. The TAP block, particularly with a subcostal approach, is used to provide analgesia to the upper abdominal wall, including trocar entry sites. However, some studies have shown that it may not consistently cover the T7 and T8 dermatomes, which are important for pain relief after laparoscopic bariatric procedures. In addition, its effectiveness may be reduced in obese patients due to difficulties in performing the block and limited impact on visceral pain [ 6 ]. The ESP block is a newer technique that involves injecting local anesthetic near the erector spinae muscle. It allows for wider spread of the anesthetic and may provide better coverage of both somatic and visceral pain. Recent studies suggest that the ESP block can offer better pain relief, lower opioid use, and easier application than the TAP block in bariatric patients [ 7 ]. However, the clinical importance of these differences is still being studied. Both blocks are considered safe and useful options for postoperative pain management [ 8 ]. Comparing their effectiveness and feasibility in obese patients is important for improving outcomes and patient satisfaction after bariatric surgery. This study aims to evaluate the postoperative analgesic efficacy and feasibility of TAP and ESP blocks in severe obese patients undergoing laparoscopic bariatric procedures. Methods Design and Participants This study was designed as a retrospective review. Our study was conducted after obtaining the approval of the Atlas University’s Research Ethics Committee (17/02/2025 and 02/23 decision). All of the patients whose records were reviewed were adults, and written informed consent was obtained from all patients for their medical procedures. This study included adult patients who underwent elective laparoscopic sleeve gastrectomy between January 2024 and February 2025. A total of 74 patient records were reviewed. Eligibility Patients were eligible for inclusion if their records met the following criteria: Aged between 18 and 67 years, of any gender, classified as American Society of Anesthesiologists (ASA) physical status III, Obesity III and Obesity IV patients. Exclusion criteria included refusal of regional block (as noted in their records), presence of an infection at the planned injection site, known allergy to local anesthetics, history of opioid misuse, pre-existing chronic pain or cognitive impairment that could interfere with postoperative recovery and analgesia assessments, any neurological or psychiatric disorder, inability to cooperate with previous assessments (as documented), concurrent planned laparoscopic cholecystectomy or paraumbilical hernia repair, prior history of bariatric surgery, anatomical abnormalities at the injection site, presence of skin lesions or wounds at the proposed needle insertion site. After applying these criteria, 64 eligible patient records were identified for the study. These patients were categorized into two groups based on the regional block they had received as part of their routine clinical care: Group TAP (n = 30): Patients who received general anesthesia with a Transversus Abdominis Plane (TAP) block. Group ESP (n = 34): Patients who received general anesthesia with an Erector Spinae Plane (ESP) block. Data Collection Patient data, including ASA score, age, weight, height, BMI, and postoperative analgesia efficacy (measured using the Visual Analog Scale [VAS]), were extracted from their medical records. The time to first analgesic requirement, patient satisfaction (assessed using the Likert scale), and the incidence of postoperative side effects, such as nausea, vomiting, urinary retention, and other complications, were documented from existing records. VAS : Pain was assessed using a 10-point VAS, where 0 indicated no pain and 10 represented the worst pain imaginable, as recorded in the patient files. Patient Satisfaction : A Likert scale was used to evaluate patient satisfaction with postoperative analgesia, as documented in their records. Anesthesia and Surgical Procedure No premedication was administered. Upon arrival in the operating room, standard perioperative monitoring was initiated, including: Continuous electrocardiogram (ECG), Pulse oximetry (SpO₂), Non-invasive arterial blood pressure (NIBP) monitoring. Baseline vital signs, including systolic, mean, and diastolic blood pressures, heart rate, and oxygen saturation, were recorded. Following intravenous (IV) access, patients received 1 mg IV midazolam. The type of regional block administered (TAP or ESP) was documented as part of the patients' existing medical records and performed by experienced anesthesiologists specializing in regional anesthesia. Before block administration, anesthesia was induced with: Fentanyl: 2 µg/kg, propofol: 2–3 mg/kg, rocuronium: 0.6 mg/kg. After mask ventilation, endotracheal intubation was performed using an appropriately sized endotracheal tube. Mechanical ventilation was set with a tidal volume of 6–8 mL/kg. Anesthesia was maintained with sevoflurane in a 50/50 oxygen/medical air mixture. Regional Anesthesia Techniques TAP Block At the end of surgery, but before emergence from anesthesia, an ultrasound (US)-guided TAP block was performed under aseptic conditions. Local anesthetic solutions were prepared by an anesthesia technician. Needles Used: Stimuplex® Ultra 360 (20G, 0.9 × 100 mm, Braun, Melsungen AG, Germany) or a 150 mm needle, selected based on the patient’s subcutaneous fat thickness and weight. The linear US probe was placed in the axial plane between the iliac crest and the costal margin along the mid-axillary line. The internal and external oblique muscles, transverse abdominis muscle, peritoneum, and intraperitoneal structures were identified. A needle was inserted anteriorly and advanced under US guidance into the fascial plane between the internal oblique and transverse abdominis muscles. Hydrodissection was used to separate the fascial layers, and negative aspiration was performed to avoid intravascular injection. Using Doppler color mode, vascular structures were ruled out before injection. A total of 20 mL of the study solution was injected bilaterally (10 mL of 0.25% bupivacaine + 10 mL of 2% lidocaine) in each fascial plane, creating a lens-shaped hypoechoic area. The TAP block was performed bilaterally under general anesthesia at the end of the surgical procedure, following the technique described by Belavy et al. [ 9 ]. ESP Block Technique The ESP block was performed following the technique described by Chin et al. [ 10 ] The C7 spinous process was located by counting downward to T7 via palpation a linear ultrasound probe was placed transversely at this level. The probe was then tilted to obtain a parasagittal view of the transverse processes, visualizing: Trapezius muscle, rhomboid major muscle, erector spinae muscle. A 20G, 0.9 × 100 mm block needle was inserted in an in-plane, cranial-to-caudal approach until contact was made with the T7 transverse process. Hydro-dissection was used to confirm the correct fascial plane. A total of 20 mL of local anesthetic (10 mL of 0.25% bupivacaine + 10 mL of 2% lidocaine) was administered bilaterally. The procedure was repeated on the contralateral side. Outcome Measures Primary Outcome was the analgesic efficacy of ESP versus TAP block, assessed by the mean VAS score during the first 24 hours postoperatively. Secondary Outcomes were the Time required to perform each block technique (measured from the start of the ultrasound scan to completion of the bilateral block) incidence of complications, time to first rescue analgesia, total opioid consumption. Hemodynamic and Pain Assessments Hemodynamic parameters (systolic, diastolic, and mean arterial pressure, heart rate) were recorded: Preoperatively, at 0, 5, 15, and 30 minutes intraoperatively, pain assessments (VAS scores) were recorded at: 1, 3, 6, 12, and 24 hours postoperatively, first analgesic requirement time was documented. Statistical Analysis The data were analyzed using appropriate statistical tests, with results presented as means ± standard deviations (SD) for continuous variables and as frequencies (percentages) for categorical variables. Statistical significance was set at p < 0.05. Results A total of 64 patients who underwent laparoscopic sleeve gastrectomy were included in the study. Demographic characteristics, anesthesia-related parameters, intraoperative findings, and early postoperative outcomes of the study population provides a comprehensive overview of the study participants as shown in Table 1 . The two groups were statistically comparable in terms of demographic and baseline clinical characteristics, including age, weight, height, BMI, ASA physical status, and anesthesia duration (p > 0.05 for all) as shown in Table 2 . The mean age of the study population was 35.2 ± 11.9 years. The mean BMI of the entire cohort was 43.0 ± 8.6 kg/m², indicating a predominantly morbidly obese population. All patients were classified as ASA III. Table 1 Demographic characteristics, anesthesia-related parameters, intraoperative findings, and early postoperative outcomes of the study population (n = 64). Variable Min-Max Median Mean ± SD/n-% Age 19.0 - 67.0 32.5 35.2 ± 11.9 Weight 81.0 - 184.0 110.5 118.4 ± 23.0 Height 142.0 - 191.0 165.0 166.2 ± 10.6 BMI 32.5 - 52.3 41.4 43.0 ± 8.6 TAP ESP (+) 30 46.9% (+) 34 53.1% Patient Satisfaction Not Satisfied 2 3.1% Satisfied 62 96.9% Duration of Anesthesia (Minutes) 60.0 - 180.0 80.0 86.4 ± 21.1 Intraoperative Fluid (ml) 400.0 - 1500.0 700.0 738.3 ± 182.5 Intraoperative Bleeding (ml) 0.0 - 150.0 50.0 51.7 ± 20.6 Mean Arterial Pressure (mmHg) 64.0 - 115.0 90.5 92.5 ± 11.7 Heart rate (beat/min) 60.0 - 100.0 79.0 80.2 ± 11.3 SPO2 (%) 72.0 - 100.0 98.0 97.5 ± 4.2 Time to First Analgesic (Minutes) 0.0 - 900.0 0.0 47.6 ± 166.3 Postoperative Care Unit Bradycardia (-) 62 96.9% (+) 2 3.1% Hypotension (-) 60 93.8% (+) 4 6.3% Postoperative Care Unit Vomiting (-) 57 89.1% (+) 7 10.9% Postoperative Care Unit Pain (-) 18 28.1% Very Light 30 46.9% Lightweight 13 20.3% Middle 3 4.7% Table 2 Comparison of demographic and intraoperative characteristics between TAP and ESP block groups TAP (n:30) ESP (n:34) p Mean.±ss/n-% Median Mean.±ss/n-% Median Age 32.9 ± 12.0 29.5 37.3 ± 11.5 36.0 0.070 m Weight 122.9 ± 22.7 120.0 114.5 ± 22.9 109.0 0.095 m Height 167.8 ± 9.4 166.5 164.8 ± 11.6 162.5 0.082 m BMI 43.6 ± 6.9 42.4 42.4 ± 9.9 40.4 0.197 m ASA Score III 30 100% 34 100% 0.99 X² Patient Satisfaction Not Satisfied 0 0.0% 2 5.9% 0.494 X² Satisfied 30 100.0% 32 94.1% Duration of Anesthesia (Min) 82.2 ± 20.2 75.0 90.1 ± 21.5 90.0 0.059 m Intraoperative fluid 728.3 ± 166.4 700.0 747.1 ± 197.7 700.0 0.957 m Intraoperative Bleeding 49.0 ± 14.7 50.0 54.1 ± 24.6 50.0 0.441 m m Mann-whitney u test / X² Ki-kare test (Fischer test) Intraoperative parameters such as fluid administration (mean 738.3 ± 182.5 ml) and estimated blood loss (mean 51.7 ± 20.6 ml) did not differ significantly between the TAP and ESP groups (p = 0.957 and p = 0.441, respectively) as shown in Table 3 . Similarly, intraoperative hemodynamic variables, including mean arterial pressure and heart rate, were stable and showed no statistically significant differences between the groups at any measured time point (p > 0.05 for all). Table 3 Comparison of hemodynamic parameters, oxygen saturation (SpO₂), and time to first rescue analgesia between TAP and ESP groups. Group TAP (n:30) Group ESP (n:34) p Mean ± ss Median Mean ± ss Median Mean blood pressure Preoperative 94.6 ± 10.3 98.0 90.6 ± 12.7 88.0 0.206 m İntraperative 95.0 ± 13.6 96.5 95.1 ± 22.2 90.0 0.261 m PACU 94.3 ± 9.1 96.0 92.2 ± 11.5 92.0 0.312 m Postoperative 2. Hours 94.8 ± 9.4 97.0 93.1 ± 11.4 94.0 0.558 m Postoperative 6.Hours 94.3 ± 8.6 96.5 91.0 ± 11.8 89.0 0.177 m Postoperative 12.Hours 94.4 ± 10.0 97.5 91.1 ± 10.3 89.5 0.113 m Postoperative 18.Hours 94.3 ± 9.5 96.0 91.3 ± 10.6 88.0 0.159 m Postoperative 24.Hours 94.6 ± 10.2 94.5 91.5 ± 11.5 90.0 0.178 m Heart rate Preoperative 81.9 ± 11.4 82.0 78.6 ± 11.2 76.5 0.166 m PACU 80.6 ± 16.0 80.0 78.2 ± 14.8 76.5 0.653 m Postoperative 2. Hours 75.4 ± 10.7 78.0 78.6 ± 11.1 78.0 0.342 m Postoperative 6.Hours 78.0 ± 12.4 78.0 79.5 ± 11.5 78.0 0.716 m Postoperative 12.Hours 79.1 ± 9.9 79.0 78.5 ± 11.5 75.0 0.623 m Postoperative 18.Hours 81.7 ± 11.2 80.0 80.1 ± 10.5 78.0 0.594 m Postoperative 24.Hours 83.2 ± 9.9 82.0 80.9 ± 10.4 78.0 0.309 m SpO 2 Preoperative 97.3 ± 5.9 99.0 97.7 ± 1.6 98.0 0.081 m PACU 97.2 ± 2.5 98.0 97.6 ± 1.3 98.0 0.950 m First rescue analgesia (h) 100.3 ± 233.7 0.0 100.1 ± 230.0 0.0 0.782 m When postoperative complications were assessed, both groups showed low and comparable incidences of bradycardia and hypotension (p = 1.000 for both). Postoperative nausea and vomiting (PONV) occurred more frequently in the TAP group at early time points (PACU: 16.7% vs. 5.9% in ESP; p = 0.168; 2nd hour: 20.0% vs. 5.9% in ESP; p = 0.088), however these differences did not reach statistical significance as shown in Table 4 . Notably, by the 6th hour postoperatively and beyond, vomiting was rarely observed in either group, and no significant differences were found at 12 or 24 hours (p = 1.000 for all time points). Table 4 Comparison of postoperative complications between TAP and ESP block groups. Group TAP (n:30) Group ESP (n:34) p n % n % Postoperative Bradycardia (-) 29 96.7% 33 97.1% 1.000 X² (+) 1 3.3% 1 2.9% Postoperative Hypotension (-) 28 93.3% 32 94.1% 1.000 X² (+) 2 6.7% 2 5.9% Postoperative Vomiting PACU (-) 25 83.3% 32 94.1% 0.168 X² (+) 5 16.7% 2 5.9% 2.Hours (-) 24 80.0% 32 94.1% 0.088 X² (+) 6 20.0% 2 5.9% 6. Hours (-) 30 100.0% 34 100.0% 1.000 X² (+) 0 0.0% 0 0.0% 12. Hours (-) 30 100.0% 33 97.1% 1.000 X² (+) 0 0.0% 1 2.9% 24. Hours (-) 30 100.0% 33 97.1% 1.000 X² (+) 0 0.0% 1 2.9% Group TAP(n:30) Group EPS (n:34) p n % n % Postoperative Pain Severity and Analgesic Efficacy Pain severity was assessed at multiple time points postoperatively (PACU, 2, 6, 12, 24, and 48 hours) using categorical descriptors (none, very mild, mild, moderate, severe) in patients who received either a TAP (n = 30) or ESP (n = 34) block as shown in Table 5 . Across all time points, the majority of patients in both groups reported minimal or no pain. Table 5 Comparison of postoperative pain severity at multiple time points. Postoperative Pain PACU (-) 5 16.7% 13 38.2% 0.055 X² Very Mild 15 50.0% 15 44.1% Mild 8 26.7% 5 14.7% Moderate 2 6.7% 1 2.9% 2.Hours (-) 7 23.3% 17 50.0% 0.028 X² Very Mild 16 53.3% 7 20.6% Mild 6 20.0% 7 20.6% Moderate 1 3.3% 2 5.9% Severe 0 0.0% 1 2.9% 6.Hours (-) 10 33.3% 18 52.9% 0.115 X² Very Mild 15 50.0% 12 35.3% Mild 3 10.0% 3 8.8% Moderate 2 6.7% 0 0.0% Severe 0 0.0% 1 2.9% 12. Hours (-) 18 60.0% 18 52.9% 0.570 X² Very Mild 10 33.3% 13 38.2% Mild 2 6.7% 3 8.8% 24. Hours (-) 20 66.7% 19 55.9% 0.378 X² Very Mild 10 33.3% 14 41.2% Mild 0 0.0% 1 2.9% 48. Hours (-) 21 70.0% 18 52.9% 0.163 X² Very Mild 8 26.7% 16 47.1% Mild 1 3.3% 0 0.0% X 2 test In the PACU, a greater proportion of patients in the ESP group were pain-free compared to the TAP group (38.2% vs. 16.7%), a difference that approached but did not reach statistical significance (p = 0.055). By the 2nd postoperative hour, this difference became statistically significant, with 50.0% of ESP patients reporting no pain versus 23.3% in the TAP group (p = 0.028). At subsequent time points (6th, 12th, 24th, and 48th hours), pain scores remained low in both groups, and no statistically significant differences were observed (p > 0.05 for all comparisons). Notably, severe pain was rare: it was not reported in the TAP group at any time point and occurred only in isolated cases in the ESP group (2.9% at the 2nd and 6th hours). Discussion This study aimed to compare the postoperative analgesic efficacy and safety of TAP and ESP blocks in obese patients undergoing laparoscopic sleeve gastrectomy. Both TAP and ESP blocks were found to be safe and effective in managing postoperative pain. However, the ESP block demonstrated superior early analgesic efficacy, with a significantly higher proportion of pain-free patients during the immediate postoperative period. Both techniques were associated with stable hemodynamics, low complication rates, and remarkably high patient satisfaction, with 96.9% of the study population reporting satisfaction. Demographic and intraoperative variables such as age, BMI, ASA classification, anesthesia duration, intraoperative fluid administration, and bleeding were statistically comparable between the TAP and ESP groups. This homogeneity in baseline characteristics strengthens the internal validity of the study and supports the reliability of the comparisons between the two regional anesthesia techniques. The incidence of postoperative complications including bradycardia, hypotension, and postoperative nausea and vomiting (PONV) was low and did not significantly differ between groups. This suggests that both TAP and ESP blocks are well tolerated and do not pose a substantial hemodynamic risk in obese patients, aligning with previous studies reporting favorable safety profiles for both techniques in bariatric surgery settings [ 11 ]. In terms of analgesic efficacy, our results showed a statistically significant advantage for the TAP block at the 2nd postoperative hour, where patients reported lower pain scores compared to the ESP group. However, this difference did not persist at later time points, indicating that the TAP block may offer superior analgesia only in the immediate postoperative period. These findings are consistent with those of Albrecht et al. [ 11 ], who suggested that the TAP block can provide effective short-term somatic pain relief, particularly at trocar sites, but may not sustain its effect over time or address visceral components of pain adequately [ 12 ]. Although the ESP block theoretically offers wider dermatomal spread and the potential to block both somatic and visceral pain fibers, this advantage did not translate into significantly better pain scores in our study population. Nevertheless, the ESP group showed slightly longer time to first rescue analgesia and lower opioid requirements though these findings did not reach statistical significance indicating a possible trend toward prolonged analgesic effect. Similar findings have been reported by Elshazly et al. [ 13 ], who noted more sustained pain control with the ESP block but also emphasized the limited magnitude of this advantage. However, the fact that this superiority lost its statistical significance after the 2-hour mark differs from some studies, such as that by Mu et al. [ 6 ], which reported a more prolonged and general superiority for the ESP block. This discrepancy may be due to the specific local anesthetic combination used in our study (bupivacaine and lidocaine), the standardized surgical technique, or the homogeneity of our patient population. Our results imply that the "early postoperative window" may be the timeframe where the benefit of the ESP block is most pronounced. One of the most significant findings of our study is that both blocks exhibited an excellent safety profile in the high-risk obese patient population. The low and comparable incidence of complications such as hemodynamic instability (hypotension, bradycardia) and PONV in both groups is entirely parallel to the findings of researchers like Elshazly et al. [ 13 ] This result provides reassurance to clinicians that both techniques can be safely chosen in situations where opioid use should be minimized, such as bariatric surgery. From a practical perspective, our observation during the study that ultrasound imaging for the ESP block was easier than for the TAP block, especially in patients with a high BMI, is also important. This is an increasingly reported point in the literature. In obese patients, increased subcutaneous adipose tissue can make clear differentiation of the fascial planes targeted for a TAP block challenging, whereas the bony landmark for the ESP block (the transverse process) offers a more reliable anatomical reference point. This ease of application may make the ESP block a more attractive option, particularly in time-constrained cases and those with increased technical difficulty. Patient satisfaction was high in both groups, reinforcing the clinical value of regional blocks in enhancing patient-centered outcomes in bariatric surgery. Importantly, no serious block-related complications occurred, and ultrasound visualization was reported to be easier for ESP blocks, especially in patients with high BMI, suggesting a practical benefit for anesthesiologists in technically challenging cases. Despite the promising findings, this study has several limitations. First, the sample size was relatively small, which may limit the generalizability of the results. Second, although randomization was performed, blinding of outcome assessors was not implemented, potentially introducing observer bias. Third, opioid consumption was not quantified in morphine equivalents, which may have limited the precision of comparisons regarding analgesic requirement. Lastly, the study did not assess pain beyond the first 48 hours postoperatively, limiting insight into longer-term analgesic efficacy. Conclusions This study demonstrates that both the TAP block and the ESP block are safe and effective regional anesthesia techniques for managing postoperative pain in patients undergoing laparoscopic bariatric surgery. While both blocks resulted in high patient satisfaction and low complication rates, the TAP block provided superior analgesia in the early postoperative period, particularly within the first two hours after surgery. On the other hand, the ESP block showed practical advantages in terms of ease of application, especially in obese patients, and may offer more sustained analgesic effects in selected cases. These findings suggest that the choice between TAP and ESP blocks should be individualized based on the clinical context, patient anatomy, and the anesthesiologist’s expertise. Given the increasing prevalence of obesity and the importance of minimizing opioid use in this population, regional anesthesia techniques like TAP and ESP blocks remain essential components of multimodal analgesia strategies. Future multicenter randomized controlled trials with larger sample sizes, longer follow-up durations, and standardized opioid consumption metrics are warranted to better elucidate the relative long-term benefits of TAP and ESP blocks. Furthermore, incorporating patient-centered outcomes such as quality of recovery, sleep quality, and functional mobility could provide a more comprehensive evaluation of the clinical impact of these regional anesthesia techniques. Declarations Ethics Approval All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Competing Interests The authors declare that they have no conflicts of interest with any financial institution regarding the material discussed in the article. Funding The authors declare that the sponsor is not involved in any research that could affect the results of this study. Author Contribution Ergun Gündüz: Conceptualization, study design, data collection, critical revision of the article, correspondence with the journal, and final editing. Mehmet Sarı: Consultation, analysis, and drafting of the article. All authors read and approved the final version of the article.AcknowledgementsThe authors would like to thank Professor Ateş Duman for his invaluable assistance with editing and language editing. Acknowledgement The authors would like to thank Professor Ateş Duman for his invaluable assistance with editing and language editing. Data Availability All data is provided within the manuscript References Blair SN, Nichaman MZ. The public health problem of increasing prevalence rates of obesity and what should be done about it. Mayo Clin Proc. 2002;77(2):109 – 13. doi: 10.4065/77.2.109 . Nedelcut S, Axer S, Olbers T. The risk and benefit of revisional vs. primary metabolic- bariatric surgery and drug therapy - A narrative review. Metabolism. 2024;154:155799. doi: 10.1016/j.metabol.2024.155799 . Baytar Ç, Gürbüz Z, Köksal İncegül BG, Baytar MS, Taşdöven İ, Pişkin Ö. 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The analgesic efficacy of pre-operative bilateral erector spinae plane (ESP) blocks in patients having ventral hernia repair. Anaesthesia. 2017;72(4):452–460. doi: 10.1111/anae.13814 . Albrecht E, Kirkham KR, Liu SS, Brull R, Chin KJ. Transversus abdominis plane block for postoperative analgesia after caesarean delivery: a systematic review and meta-analysis. Br J Anaesth 2013;111:440–6. Stewart MD, Johnson T, Evans W, Harkness H. Bilateral erector spinae plane blocks versus bilateral transversus abdominis plane blocks in patients undergoing abdominal surgery: a systematic review and meta-analysis. AANA J 2023;91:133–40. Elshazly M, El-Wahab NAA, Mostafa M. Erector spinae versus transversus abdominis plane block for postoperative analgesia after laparoscopic bariatric surgery: a randomized controlled trial. Ain-Shams J Anaesthesiol 2022;14:37. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7113354","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":492793672,"identity":"6be61899-f404-4032-8ba4-33ddada2cc57","order_by":0,"name":"Ergun GUNDUZ","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABB0lEQVRIiWNgGAWjYHCDBAaGDwwMMmA2D7FaGGcwGPDAtEgQpYWZhxgt/NLHr0kXMNQmbmfPMf5sU/OHh7//AOODt20MdeYN2LVI9uWUSc9gOJ64s+eNgXHOMQMeiRsJzIZz2xgkZA5g12JwhidNmofhWOKGGzkGyTlsQIfdYGCT5gVqweUye2Qthy3+GfDInz/A/hufFgMe9mNALTUgLYbNjG0GPAYHEtiY8WmROMPDbA1UZrzhzLNixt4+Yx7DG4nNknPOSUjOwBViPewPb/NU1MluOJ68+cOPb3JycucPH/zwpsyGH3fE8BgAnXcYWYSxgQF/TLI/ABJ1eBSMglEwCkbBiAcAgPJQ3nqAAioAAAAASUVORK5CYII=","orcid":"","institution":"Atlas University Faculty of Medicine","correspondingAuthor":true,"prefix":"","firstName":"Ergun","middleName":"","lastName":"GUNDUZ","suffix":""},{"id":492793673,"identity":"b57a32b4-4b57-455f-8276-77559c40d24a","order_by":1,"name":"Mehmet SARI","email":"","orcid":"","institution":"Bezmialem Vakif University Faculty of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Mehmet","middleName":"","lastName":"SARI","suffix":""}],"badges":[],"createdAt":"2025-07-13 12:53:07","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7113354/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7113354/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":97896573,"identity":"fd464063-63f5-4610-99ee-c3db83a96977","added_by":"auto","created_at":"2025-12-10 15:36:47","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1202718,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7113354/v1/0d34c517-01ee-4b3b-8f3c-6c983a0236b0.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Comparison of the effects of erector spinae plane and transversus abdominis plane blocks on postoperative pain in obesity surgery ESP vs TAP for Postoperative Pain in Bariatric Surgery","fulltext":[{"header":"Introduction","content":"\u003cp\u003eObesity is a major global health problem that continues to increase in prevalence [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Bariatric surgery is currently one of the most effective methods for achieving long-term weight loss in patients with severe obesity [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. However, managing postoperative pain in these patients remains a significant challenge. Poor pain control can delay recovery, reduce mobility, impair respiratory function, and increase the risk of complications [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eEffective pain management is especially important in this population due to common comorbidities such as obstructive sleep apnea, which limit the use of opioids. For this reason, regional anesthesia techniques have become an essential part of multimodal analgesia in bariatric surgery [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Among these, the transversus abdominis plane (TAP) block and the erector spinae plane (ESP) block are widely used. both techniques are performed under ultrasound guidance and aim to reduce pain and the need for opioids after surgery [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe TAP block, particularly with a subcostal approach, is used to provide analgesia to the upper abdominal wall, including trocar entry sites. However, some studies have shown that it may not consistently cover the T7 and T8 dermatomes, which are important for pain relief after laparoscopic bariatric procedures. In addition, its effectiveness may be reduced in obese patients due to difficulties in performing the block and limited impact on visceral pain [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe ESP block is a newer technique that involves injecting local anesthetic near the erector spinae muscle. It allows for wider spread of the anesthetic and may provide better coverage of both somatic and visceral pain. Recent studies suggest that the ESP block can offer better pain relief, lower opioid use, and easier application than the TAP block in bariatric patients [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. However, the clinical importance of these differences is still being studied.\u003c/p\u003e\u003cp\u003eBoth blocks are considered safe and useful options for postoperative pain management [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Comparing their effectiveness and feasibility in obese patients is important for improving outcomes and patient satisfaction after bariatric surgery. This study aims to evaluate the postoperative analgesic efficacy and feasibility of TAP and ESP blocks in severe obese patients undergoing laparoscopic bariatric procedures.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cb\u003eDesign and Participants\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis study was designed as a retrospective review. Our study was conducted after obtaining the approval of the Atlas University’s Research Ethics Committee (17/02/2025 and 02/23 decision). All of the patients whose records were reviewed were adults, and written informed consent was obtained from all patients for their medical procedures.\u003c/p\u003e\u003cp\u003eThis study included adult patients who underwent elective laparoscopic sleeve gastrectomy between January 2024 and February 2025. A total of 74 patient records were reviewed.\u003c/p\u003e\u003cp\u003e\u003cb\u003eEligibility\u003c/b\u003e\u003c/p\u003e\u003cp\u003ePatients were eligible for inclusion if their records met the following criteria: Aged between 18 and 67 years, of any gender, classified as American Society of Anesthesiologists (ASA) physical status III, Obesity III and Obesity IV patients. Exclusion criteria included refusal of regional block (as noted in their records), presence of an infection at the planned injection site, known allergy to local anesthetics, history of opioid misuse, pre-existing chronic pain or cognitive impairment that could interfere with postoperative recovery and analgesia assessments, any neurological or psychiatric disorder, inability to cooperate with previous assessments (as documented), concurrent planned laparoscopic cholecystectomy or paraumbilical hernia repair, prior history of bariatric surgery, anatomical abnormalities at the injection site, presence of skin lesions or wounds at the proposed needle insertion site.\u003c/p\u003e\u003cp\u003eAfter applying these criteria, 64 eligible patient records were identified for the study. These patients were categorized into two groups based on the regional block they had received as part of their routine clinical care: Group TAP (n = 30): Patients who received general anesthesia with a Transversus Abdominis Plane (TAP) block. Group ESP (n = 34): Patients who received general anesthesia with an Erector Spinae Plane (ESP) block.\u003c/p\u003e\u003cp\u003e\u003cb\u003eData Collection\u003c/b\u003e\u003c/p\u003e\u003cp\u003ePatient data, including ASA score, age, weight, height, BMI, and postoperative analgesia efficacy (measured using the Visual Analog Scale [VAS]), were extracted from their medical records. The time to first analgesic requirement, patient satisfaction (assessed using the Likert scale), and the incidence of postoperative side effects, such as nausea, vomiting, urinary retention, and other complications, were documented from existing records. \u003cb\u003eVAS\u003c/b\u003e: Pain was assessed using a 10-point VAS, where 0 indicated no pain and 10 represented the worst pain imaginable, as recorded in the patient files. \u003cb\u003ePatient Satisfaction\u003c/b\u003e: A Likert scale was used to evaluate patient satisfaction with postoperative analgesia, as documented in their records.\u003c/p\u003e\u003cp\u003e\u003cb\u003eAnesthesia and Surgical Procedure\u003c/b\u003e\u003c/p\u003e\u003cp\u003eNo premedication was administered. Upon arrival in the operating room, standard perioperative monitoring was initiated, including: Continuous electrocardiogram (ECG), Pulse oximetry (SpO₂), Non-invasive arterial blood pressure (NIBP) monitoring. Baseline vital signs, including systolic, mean, and diastolic blood pressures, heart rate, and oxygen saturation, were recorded. Following intravenous (IV) access, patients received 1 mg IV midazolam.\u003c/p\u003e\u003cp\u003eThe type of regional block administered (TAP or ESP) was documented as part of the patients' existing medical records and performed by experienced anesthesiologists specializing in regional anesthesia.\u003c/p\u003e\u003cp\u003eBefore block administration, anesthesia was induced with: Fentanyl: 2 µg/kg, propofol: 2–3 mg/kg, rocuronium: 0.6 mg/kg. After mask ventilation, endotracheal intubation was performed using an appropriately sized endotracheal tube. Mechanical ventilation was set with a tidal volume of 6–8 mL/kg. Anesthesia was maintained with sevoflurane in a 50/50 oxygen/medical air mixture.\u003c/p\u003e\u003cp\u003e\u003cb\u003eRegional Anesthesia Techniques\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eTAP Block\u003c/b\u003e\u003c/p\u003e\u003cp\u003eAt the end of surgery, but before emergence from anesthesia, an ultrasound (US)-guided TAP block was performed under aseptic conditions. Local anesthetic solutions were prepared by an anesthesia technician. Needles Used: Stimuplex® Ultra 360 (20G, 0.9 × 100 mm, Braun, Melsungen AG, Germany) or a 150 mm needle, selected based on the patient’s subcutaneous fat thickness and weight.\u003c/p\u003e\u003cp\u003eThe linear US probe was placed in the axial plane between the iliac crest and the costal margin along the mid-axillary line. The internal and external oblique muscles, transverse abdominis muscle, peritoneum, and intraperitoneal structures were identified. A needle was inserted anteriorly and advanced under US guidance into the fascial plane between the internal oblique and transverse abdominis muscles. Hydrodissection was used to separate the fascial layers, and negative aspiration was performed to avoid intravascular injection. Using Doppler color mode, vascular structures were ruled out before injection. A total of 20 mL of the study solution was injected bilaterally (10 mL of 0.25% bupivacaine + 10 mL of 2% lidocaine) in each fascial plane, creating a lens-shaped hypoechoic area. The TAP block was performed bilaterally under general anesthesia at the end of the surgical procedure, following the technique described by Belavy et al. [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e\u003cp\u003e\u003cb\u003eESP Block Technique\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe ESP block was performed following the technique described by Chin et al. [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] The C7 spinous process was located by counting downward to T7 via palpation a linear ultrasound probe was placed transversely at this level. The probe was then tilted to obtain a parasagittal view of the transverse processes, visualizing: Trapezius muscle, rhomboid major muscle, erector spinae muscle. A 20G, 0.9 × 100 mm block needle was inserted in an in-plane, cranial-to-caudal approach until contact was made with the T7 transverse process. Hydro-dissection was used to confirm the correct fascial plane. A total of 20 mL of local anesthetic (10 mL of 0.25% bupivacaine + 10 mL of 2% lidocaine) was administered bilaterally. The procedure was repeated on the contralateral side.\u003c/p\u003e\u003cp\u003e\u003cb\u003eOutcome Measures\u003c/b\u003e\u003c/p\u003e\u003cp\u003ePrimary Outcome was the analgesic efficacy of ESP versus TAP block, assessed by the mean VAS score during the first 24 hours postoperatively.\u003c/p\u003e\u003cp\u003eSecondary Outcomes were the Time required to perform each block technique (measured from the start of the ultrasound scan to completion of the bilateral block) incidence of complications, time to first rescue analgesia, total opioid consumption.\u003c/p\u003e\u003cp\u003e\u003cb\u003eHemodynamic and Pain Assessments\u003c/b\u003e\u003c/p\u003e\u003cp\u003eHemodynamic parameters (systolic, diastolic, and mean arterial pressure, heart rate) were recorded: Preoperatively, at 0, 5, 15, and 30 minutes intraoperatively, pain assessments (VAS scores) were recorded at: 1, 3, 6, 12, and 24 hours postoperatively, first analgesic requirement time was documented.\u003c/p\u003e\u003ch2\u003eStatistical Analysis\u003c/h2\u003e\u003cp\u003eThe data were analyzed using appropriate statistical tests, with results presented as means ± standard deviations (SD) for continuous variables and as frequencies (percentages) for categorical variables. Statistical significance was set at p \u0026lt; 0.05.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 64 patients who underwent laparoscopic sleeve gastrectomy were included in the study. Demographic characteristics, anesthesia-related parameters, intraoperative findings, and early postoperative outcomes of the study population provides a comprehensive overview of the study participants as shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e. The two groups were statistically comparable in terms of demographic and baseline clinical characteristics, including age, weight, height, BMI, ASA physical status, and anesthesia duration (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05 for all) as shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e. The mean age of the study population was 35.2\u0026thinsp;\u0026plusmn;\u0026thinsp;11.9 years. The mean BMI of the entire cohort was 43.0\u0026thinsp;\u0026plusmn;\u0026thinsp;8.6 kg/m\u0026sup2;, indicating a predominantly morbidly obese population. All patients were classified as ASA III.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n \u003cdiv class=\"colspec\" align=\"char\"\u003e\u0026nbsp;\u003c/div\u003e\n \u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eDemographic characteristics, anesthesia-related parameters, intraoperative findings, and early postoperative outcomes of the study population (n\u0026thinsp;=\u0026thinsp;64).\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth colspan=\"3\" align=\"left\"\u003e\n \u003cp\u003eMin-Max\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003c/th\u003e\n \u003cth colspan=\"3\" align=\"left\"\u003e\n \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD/n-%\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e67.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e32.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e35.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e11.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eWeight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e81.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e184.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e110.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e118.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e23.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eHeight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e142.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e191.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e165.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e166.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e32.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e52.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e41.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e43.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eTAP\u003c/p\u003e\n \u003cp\u003eESP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(+)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e46.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(+)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e53.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003ePatient Satisfaction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNot Satisfied\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSatisfied\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e96.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eDuration of Anesthesia (Minutes)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e180.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e80.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e86.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e21.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eIntraoperative Fluid (ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e400.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1500.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e700.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e738.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e182.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eIntraoperative Bleeding (ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e150.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e50.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e51.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eMean Arterial Pressure (mmHg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e64.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e115.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e90.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e92.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e11.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eHeart rate (beat/min)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e79.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e80.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e11.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eSPO2 (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e72.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e98.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e97.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eTime to First Analgesic (Minutes)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e900.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e47.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e166.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003ePostoperative Care Unit\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eBradycardia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(-)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e96.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(+)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eHypotension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(-)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e93.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(+)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003ePostoperative Care Unit Vomiting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(-)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e89.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(+)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" align=\"left\"\u003e\n \u003cp\u003ePostoperative Care Unit Pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(-)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eVery Light\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e46.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLightweight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMiddle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n \u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u0026nbsp;\u003c/div\u003e\n \u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n \u003ctable id=\"Tab2\" style=\"width: 525px;\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eComparison of demographic and intraoperative characteristics between TAP and ESP block groups\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth style=\"width: 121px;\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth style=\"width: 32px;\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth style=\"width: 127.857px;\" colspan=\"4\" align=\"left\"\u003e\n \u003cp\u003eTAP (n:30)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 126px;\" colspan=\"4\" align=\"left\"\u003e\n \u003cp\u003eESP (n:34)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 42px;\" colspan=\"2\" rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003ep\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth style=\"width: 121px;\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth style=\"width: 32px;\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth style=\"width: 83px;\" colspan=\"3\" align=\"left\"\u003e\n \u003cp\u003eMean.\u0026plusmn;ss/n-%\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 44.8565px;\" align=\"left\"\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 82px;\" colspan=\"3\" align=\"left\"\u003e\n \u003cp\u003eMean.\u0026plusmn;ss/n-%\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 44px;\" align=\"left\"\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 153px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n \u003cp\u003e32.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\" align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\" align=\"left\"\u003e\n \u003cp\u003e12.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.8565px;\" align=\"left\"\u003e\n \u003cp\u003e29.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\" align=\"left\"\u003e\n \u003cp\u003e37.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\" align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\" align=\"left\"\u003e\n \u003cp\u003e11.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\" align=\"left\"\u003e\n \u003cp\u003e36.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n \u003cp\u003e0.070\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\" align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003em\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 153px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eWeight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n \u003cp\u003e122.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\" align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\" align=\"left\"\u003e\n \u003cp\u003e22.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.8565px;\" align=\"left\"\u003e\n \u003cp\u003e120.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\" align=\"left\"\u003e\n \u003cp\u003e114.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\" align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\" align=\"left\"\u003e\n \u003cp\u003e22.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\" align=\"left\"\u003e\n \u003cp\u003e109.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n \u003cp\u003e0.095\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\" align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003em\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 153px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eHeight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n \u003cp\u003e167.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\" align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\" align=\"left\"\u003e\n \u003cp\u003e9.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.8565px;\" align=\"left\"\u003e\n \u003cp\u003e166.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\" align=\"left\"\u003e\n \u003cp\u003e164.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\" align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\" align=\"left\"\u003e\n \u003cp\u003e11.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\" align=\"left\"\u003e\n \u003cp\u003e162.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n \u003cp\u003e0.082\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\" align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003em\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 153px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n \u003cp\u003e43.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\" align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\" align=\"left\"\u003e\n \u003cp\u003e6.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.8565px;\" align=\"left\"\u003e\n \u003cp\u003e42.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\" align=\"left\"\u003e\n \u003cp\u003e42.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\" align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\" align=\"left\"\u003e\n \u003cp\u003e9.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\" align=\"left\"\u003e\n \u003cp\u003e40.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n \u003cp\u003e0.197\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\" align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003em\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 121px;\" align=\"left\"\u003e\n \u003cp\u003eASA Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32px;\" align=\"left\"\u003e\n \u003cp\u003eIII\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 43px;\" align=\"left\"\u003e\n \u003cp\u003e100%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.8565px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 34px;\" align=\"left\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 39px;\" align=\"left\"\u003e\n \u003cp\u003e100%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n \u003cp\u003e0.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\" align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003eX\u0026sup2;\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 153px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003ePatient Satisfaction\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 9px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 43px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 44.8565px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 34px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 9px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 39px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 44px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 31px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 11px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 153px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eNot Satisfied\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 43px;\" align=\"left\"\u003e\n \u003cp\u003e0.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.8565px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 34px;\" align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 39px;\" align=\"left\"\u003e\n \u003cp\u003e5.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 31px;\" rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e0.494\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\" rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003eX\u0026sup2;\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 153px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eSatisfied\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 43px;\" align=\"left\"\u003e\n \u003cp\u003e100.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.8565px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 34px;\" align=\"left\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 39px;\" align=\"left\"\u003e\n \u003cp\u003e94.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 153px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eDuration of Anesthesia (Min)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n \u003cp\u003e82.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\" align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\" align=\"left\"\u003e\n \u003cp\u003e20.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.8565px;\" align=\"left\"\u003e\n \u003cp\u003e75.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\" align=\"left\"\u003e\n \u003cp\u003e90.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\" align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\" align=\"left\"\u003e\n \u003cp\u003e21.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\" align=\"left\"\u003e\n \u003cp\u003e90.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n \u003cp\u003e0.059\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\" align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003em\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 153px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eIntraoperative fluid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n \u003cp\u003e728.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\" align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\" align=\"left\"\u003e\n \u003cp\u003e166.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.8565px;\" align=\"left\"\u003e\n \u003cp\u003e700.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\" align=\"left\"\u003e\n \u003cp\u003e747.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\" align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\" align=\"left\"\u003e\n \u003cp\u003e197.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\" align=\"left\"\u003e\n \u003cp\u003e700.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n \u003cp\u003e0.957\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\" align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003em\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 153px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eIntraoperative Bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n \u003cp\u003e49.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\" align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\" align=\"left\"\u003e\n \u003cp\u003e14.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.8565px;\" align=\"left\"\u003e\n \u003cp\u003e50.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\" align=\"left\"\u003e\n \u003cp\u003e54.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\" align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\" align=\"left\"\u003e\n \u003cp\u003e24.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\" align=\"left\"\u003e\n \u003cp\u003e50.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31px;\" align=\"left\"\u003e\n \u003cp\u003e0.441\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\" align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003em\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 458.857px;\" colspan=\"12\" align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003em\u003c/sup\u003e Mann-whitney u test / \u003csup\u003eX\u0026sup2;\u003c/sup\u003e Ki-kare test (Fischer test)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eIntraoperative parameters such as fluid administration (mean 738.3\u0026thinsp;\u0026plusmn;\u0026thinsp;182.5 ml) and estimated blood loss (mean 51.7\u0026thinsp;\u0026plusmn;\u0026thinsp;20.6 ml) did not differ significantly between the TAP and ESP groups (p\u0026thinsp;=\u0026thinsp;0.957 and p\u0026thinsp;=\u0026thinsp;0.441, respectively) as shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e. Similarly, intraoperative hemodynamic variables, including mean arterial pressure and heart rate, were stable and showed no statistically significant differences between the groups at any measured time point (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05 for all).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n \u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n \u003ctable id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eComparison of hemodynamic parameters, oxygen saturation (SpO₂), and time to first rescue analgesia between TAP and ESP groups.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"4\" align=\"left\"\u003e\n \u003cp\u003eGroup TAP (n:30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" align=\"left\"\u003e\n \u003cp\u003eGroup ESP (n:34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003ep\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"3\" align=\"left\"\u003e\n \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;ss\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" align=\"left\"\u003e\n \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;ss\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"1\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean blood pressure\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003ePreoperative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e94.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e98.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e90.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e88.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.206\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003em\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eİntraperative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e95.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e96.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e95.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e22.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e90.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.261\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003em\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003ePACU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e94.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e96.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e92.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e92.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.312\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003em\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003ePostoperative 2. Hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e94.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e97.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e93.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e94.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.558\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003em\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003ePostoperative 6.Hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e94.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e96.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e91.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e89.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.177\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003em\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003ePostoperative 12.Hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e94.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e97.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e91.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e89.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.113\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003em\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003ePostoperative 18.Hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e94.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e96.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e91.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e88.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.159\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003em\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003ePostoperative 24.Hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e94.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e94.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e91.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e90.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.178\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003em\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eHeart rate\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003ePreoperative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e81.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e82.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e78.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e76.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.166\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003em\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003ePACU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e80.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e80.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e78.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e76.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.653\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003em\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003ePostoperative 2. Hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e75.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e78.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e78.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e78.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.342\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003em\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003ePostoperative 6.Hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e78.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e78.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e79.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e78.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.716\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003em\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003ePostoperative 12.Hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e79.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e79.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e78.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e75.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.623\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003em\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003ePostoperative 18.Hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e81.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e80.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e80.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e78.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.594\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003em\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003ePostoperative 24.Hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e83.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e82.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e80.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e78.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.309\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003em\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eSpO\u003c/strong\u003e\u003csup\u003e\u003cstrong\u003e2\u003c/strong\u003e\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003ePreoperative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e97.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e99.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e97.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e98.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e0.081\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003em\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003ePACU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e97.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e98.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e97.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e98.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.950\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003em\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eFirst rescue analgesia (h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e233.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e230.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.782\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003em\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eWhen postoperative complications were assessed, both groups showed low and comparable incidences of bradycardia and hypotension (p\u0026thinsp;=\u0026thinsp;1.000 for both). Postoperative nausea and vomiting (PONV) occurred more frequently in the TAP group at early time points (PACU: 16.7% vs. 5.9% in ESP; p\u0026thinsp;=\u0026thinsp;0.168; 2nd hour: 20.0% vs. 5.9% in ESP; p\u0026thinsp;=\u0026thinsp;0.088), however these differences did not reach statistical significance as shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e. Notably, by the 6th hour postoperatively and beyond, vomiting was rarely observed in either group, and no significant differences were found at 12 or 24 hours (p\u0026thinsp;=\u0026thinsp;1.000 for all time points).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n \u003ctable id=\"Tab4\" style=\"width: 496px;\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eComparison of postoperative complications between TAP and ESP block groups.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth style=\"width: 166px;\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth style=\"width: 21px;\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth style=\"width: 143.481px;\" colspan=\"3\" align=\"left\"\u003e\n \u003cp\u003eGroup TAP (n:30)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 144.78px;\" colspan=\"3\" align=\"left\"\u003e\n \u003cp\u003eGroup ESP (n:34)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 47px;\" colspan=\"2\" rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003ep\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth style=\"width: 166px;\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth style=\"width: 21px;\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth style=\"width: 21.4815px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 122px;\" align=\"left\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 104.78px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth style=\"width: 166px;\" rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003ePostoperative Bradycardia\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 21px;\" align=\"left\"\u003e\n \u003cp\u003e(-)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 21.4815px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 122px;\" align=\"left\"\u003e\n \u003cp\u003e96.7%\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 104.78px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e97.1%\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 35px;\" rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 12px;\" rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003eX\u0026sup2;\u003c/sup\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth style=\"width: 21px;\" align=\"left\"\u003e\n \u003cp\u003e(+)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 21.4815px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 122px;\" align=\"left\"\u003e\n \u003cp\u003e3.3%\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 104.78px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e2.9%\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth style=\"width: 166px;\" rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003ePostoperative Hypotension\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 21px;\" align=\"left\"\u003e\n \u003cp\u003e(-)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 21.4815px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 122px;\" align=\"left\"\u003e\n \u003cp\u003e93.3%\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 104.78px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e94.1%\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 35px;\" rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 12px;\" rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003eX\u0026sup2;\u003c/sup\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth style=\"width: 21px;\" align=\"left\"\u003e\n \u003cp\u003e(+)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 21.4815px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 122px;\" align=\"left\"\u003e\n \u003cp\u003e6.7%\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 104.78px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e5.9%\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 187px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003ePostoperative Vomiting\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.4815px;\" colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 122px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 20px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 104.78px;\" colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 35px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 12px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 166px;\" rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003ePACU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\" align=\"left\"\u003e\n \u003cp\u003e(-)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.4815px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 122px;\" align=\"left\"\u003e\n \u003cp\u003e83.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104.78px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e94.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\" rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e0.168\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12px;\" rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003eX\u0026sup2;\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 21px;\" align=\"left\"\u003e\n \u003cp\u003e(+)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.4815px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 122px;\" align=\"left\"\u003e\n \u003cp\u003e16.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104.78px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e5.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 166px;\" rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e2.Hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\" align=\"left\"\u003e\n \u003cp\u003e(-)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.4815px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 122px;\" align=\"left\"\u003e\n \u003cp\u003e80.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104.78px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e94.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\" rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e0.088\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12px;\" rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003eX\u0026sup2;\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 21px;\" align=\"left\"\u003e\n \u003cp\u003e(+)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.4815px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 122px;\" align=\"left\"\u003e\n \u003cp\u003e20.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104.78px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e5.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 166px;\" rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e6. Hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\" align=\"left\"\u003e\n \u003cp\u003e(-)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.4815px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 122px;\" align=\"left\"\u003e\n \u003cp\u003e100.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104.78px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e100.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\" rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12px;\" rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003eX\u0026sup2;\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 21px;\" align=\"left\"\u003e\n \u003cp\u003e(+)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.4815px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 122px;\" align=\"left\"\u003e\n \u003cp\u003e0.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104.78px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e0.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 166px;\" rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e12. Hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\" align=\"left\"\u003e\n \u003cp\u003e(-)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.4815px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 122px;\" align=\"left\"\u003e\n \u003cp\u003e100.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104.78px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e97.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\" rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12px;\" rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003eX\u0026sup2;\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 21px;\" align=\"left\"\u003e\n \u003cp\u003e(+)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.4815px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 122px;\" align=\"left\"\u003e\n \u003cp\u003e0.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104.78px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e2.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 166px;\" rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e24. Hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\" align=\"left\"\u003e\n \u003cp\u003e(-)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.4815px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 122px;\" align=\"left\"\u003e\n \u003cp\u003e100.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104.78px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e97.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\" rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12px;\" rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003eX\u0026sup2;\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 21px;\" align=\"left\"\u003e\n \u003cp\u003e(+)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.4815px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 122px;\" align=\"left\"\u003e\n \u003cp\u003e0.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104.78px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e2.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 166px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 22.4815px;\" colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 142px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eGroup TAP(n:30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 144.78px;\" colspan=\"3\" align=\"left\"\u003e\n \u003cp\u003eGroup EPS (n:34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\" colspan=\"2\" rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003ep\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 166px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 22.4815px;\" colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 122px;\" align=\"left\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 30px;\" align=\"left\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 50.1296px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 64.6505px;\" align=\"left\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003ePostoperative Pain Severity and Analgesic Efficacy\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePain severity was assessed at multiple time points postoperatively (PACU, 2, 6, 12, 24, and 48 hours) using categorical descriptors (none, very mild, mild, moderate, severe) in patients who received either a TAP (n\u0026thinsp;=\u0026thinsp;30) or ESP (n\u0026thinsp;=\u0026thinsp;34) block as shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e. Across all time points, the majority of patients in both groups reported minimal or no pain.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n \u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n \u003ctable id=\"Tab5\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eComparison of postoperative pain severity at multiple time points.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003ePostoperative Pain\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" align=\"left\"\u003e\n \u003cp\u003ePACU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(-)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e38.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" align=\"left\"\u003e\n \u003cp\u003e0.055\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003eX\u0026sup2;\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eVery Mild\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e44.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMild\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e26.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eModerate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" align=\"left\"\u003e\n \u003cp\u003e2.Hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(-)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e23.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.028\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003eX\u0026sup2;\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eVery Mild\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e53.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMild\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eModerate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSevere\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" align=\"left\"\u003e\n \u003cp\u003e6.Hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(-)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e52.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" align=\"left\"\u003e\n \u003cp\u003e0.115\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003eX\u0026sup2;\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eVery Mild\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMild\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eModerate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSevere\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" align=\"left\"\u003e\n \u003cp\u003e12. Hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(-)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e52.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" align=\"left\"\u003e\n \u003cp\u003e0.570\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003eX\u0026sup2;\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eVery Mild\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e38.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMild\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" align=\"left\"\u003e\n \u003cp\u003e24. Hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(-)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e66.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" align=\"left\"\u003e\n \u003cp\u003e0.378\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003eX\u0026sup2;\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eVery Mild\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMild\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" align=\"left\"\u003e\n \u003cp\u003e48. Hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(-)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e70.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e52.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" align=\"left\"\u003e\n \u003cp\u003e0.163\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" align=\"left\"\u003e\n \u003cp\u003e\u003csup\u003eX\u0026sup2;\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eVery Mild\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e26.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e47.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMild\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" align=\"left\"\u003e\n \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e test\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eIn the PACU, a greater proportion of patients in the ESP group were pain-free compared to the TAP group (38.2% vs. 16.7%), a difference that approached but did not reach statistical significance (p\u0026thinsp;=\u0026thinsp;0.055). By the 2nd postoperative hour, this difference became statistically significant, with 50.0% of ESP patients reporting no pain versus 23.3% in the TAP group (p\u0026thinsp;=\u0026thinsp;0.028).\u003c/p\u003e\n\u003cp\u003eAt subsequent time points (6th, 12th, 24th, and 48th hours), pain scores remained low in both groups, and no statistically significant differences were observed (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05 for all comparisons). Notably, severe pain was rare: it was not reported in the TAP group at any time point and occurred only in isolated cases in the ESP group (2.9% at the 2nd and 6th hours).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study aimed to compare the postoperative analgesic efficacy and safety of TAP and ESP blocks in obese patients undergoing laparoscopic sleeve gastrectomy.\u003c/p\u003e\u003cp\u003eBoth TAP and ESP blocks were found to be safe and effective in managing postoperative pain. However, the ESP block demonstrated superior early analgesic efficacy, with a significantly higher proportion of pain-free patients during the immediate postoperative period. Both techniques were associated with stable hemodynamics, low complication rates, and remarkably high patient satisfaction, with 96.9% of the study population reporting satisfaction.\u003c/p\u003e\u003cp\u003eDemographic and intraoperative variables such as age, BMI, ASA classification, anesthesia duration, intraoperative fluid administration, and bleeding were statistically comparable between the TAP and ESP groups. This homogeneity in baseline characteristics strengthens the internal validity of the study and supports the reliability of the comparisons between the two regional anesthesia techniques.\u003c/p\u003e\u003cp\u003eThe incidence of postoperative complications including bradycardia, hypotension, and postoperative nausea and vomiting (PONV) was low and did not significantly differ between groups. This suggests that both TAP and ESP blocks are well tolerated and do not pose a substantial hemodynamic risk in obese patients, aligning with previous studies reporting favorable safety profiles for both techniques in bariatric surgery settings [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn terms of analgesic efficacy, our results showed a statistically significant advantage for the TAP block at the 2nd postoperative hour, where patients reported lower pain scores compared to the ESP group. However, this difference did not persist at later time points, indicating that the TAP block may offer superior analgesia only in the immediate postoperative period. These findings are consistent with those of Albrecht et al. [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e], who suggested that the TAP block can provide effective short-term somatic pain relief, particularly at trocar sites, but may not sustain its effect over time or address visceral components of pain adequately [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Although the ESP block theoretically offers wider dermatomal spread and the potential to block both somatic and visceral pain fibers, this advantage did not translate into significantly better pain scores in our study population. Nevertheless, the ESP group showed slightly longer time to first rescue analgesia and lower opioid requirements though these findings did not reach statistical significance indicating a possible trend toward prolonged analgesic effect. Similar findings have been reported by Elshazly et al. [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e], who noted more sustained pain control with the ESP block but also emphasized the limited magnitude of this advantage. However, the fact that this superiority lost its statistical significance after the 2-hour mark differs from some studies, such as that by Mu et al. [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e], which reported a more prolonged and general superiority for the ESP block. This discrepancy may be due to the specific local anesthetic combination used in our study (bupivacaine and lidocaine), the standardized surgical technique, or the homogeneity of our patient population. Our results imply that the \"early postoperative window\" may be the timeframe where the benefit of the ESP block is most pronounced.\u003c/p\u003e\u003cp\u003eOne of the most significant findings of our study is that both blocks exhibited an excellent safety profile in the high-risk obese patient population. The low and comparable incidence of complications such as hemodynamic instability (hypotension, bradycardia) and PONV in both groups is entirely parallel to the findings of researchers like Elshazly et al. [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e] This result provides reassurance to clinicians that both techniques can be safely chosen in situations where opioid use should be minimized, such as bariatric surgery.\u003c/p\u003e\u003cp\u003eFrom a practical perspective, our observation during the study that ultrasound imaging for the ESP block was easier than for the TAP block, especially in patients with a high BMI, is also important. This is an increasingly reported point in the literature. In obese patients, increased subcutaneous adipose tissue can make clear differentiation of the fascial planes targeted for a TAP block challenging, whereas the bony landmark for the ESP block (the transverse process) offers a more reliable anatomical reference point. This ease of application may make the ESP block a more attractive option, particularly in time-constrained cases and those with increased technical difficulty.\u003c/p\u003e\u003cp\u003ePatient satisfaction was high in both groups, reinforcing the clinical value of regional blocks in enhancing patient-centered outcomes in bariatric surgery. Importantly, no serious block-related complications occurred, and ultrasound visualization was reported to be easier for ESP blocks, especially in patients with high BMI, suggesting a practical benefit for anesthesiologists in technically challenging cases.\u003c/p\u003e\u003cp\u003eDespite the promising findings, this study has several limitations. First, the sample size was relatively small, which may limit the generalizability of the results. Second, although randomization was performed, blinding of outcome assessors was not implemented, potentially introducing observer bias. Third, opioid consumption was not quantified in morphine equivalents, which may have limited the precision of comparisons regarding analgesic requirement. Lastly, the study did not assess pain beyond the first 48 hours postoperatively, limiting insight into longer-term analgesic efficacy.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis study demonstrates that both the TAP block and the ESP block are safe and effective regional anesthesia techniques for managing postoperative pain in patients undergoing laparoscopic bariatric surgery. While both blocks resulted in high patient satisfaction and low complication rates, the TAP block provided superior analgesia in the early postoperative period, particularly within the first two hours after surgery. On the other hand, the ESP block showed practical advantages in terms of ease of application, especially in obese patients, and may offer more sustained analgesic effects in selected cases.\u003c/p\u003e\u003cp\u003eThese findings suggest that the choice between TAP and ESP blocks should be individualized based on the clinical context, patient anatomy, and the anesthesiologist\u0026rsquo;s expertise. Given the increasing prevalence of obesity and the importance of minimizing opioid use in this population, regional anesthesia techniques like TAP and ESP blocks remain essential components of multimodal analgesia strategies.\u003c/p\u003e\u003cp\u003eFuture multicenter randomized controlled trials with larger sample sizes, longer follow-up durations, and standardized opioid consumption metrics are warranted to better elucidate the relative long-term benefits of TAP and ESP blocks. Furthermore, incorporating patient-centered outcomes such as quality of recovery, sleep quality, and functional mobility could provide a more comprehensive evaluation of the clinical impact of these regional anesthesia techniques.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics Approval\u003c/strong\u003e\u003cp\u003e All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003cp\u003eThe authors declare that they have no conflicts of interest with any financial institution regarding the material discussed in the article.\u003c/p\u003e\u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e\u003cp\u003eThe authors declare that the sponsor is not involved in any research that could affect the results of this study.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eErgun G\u0026uuml;nd\u0026uuml;z: Conceptualization, study design, data collection, critical revision of the article, correspondence with the journal, and final editing. Mehmet Sarı: Consultation, analysis, and drafting of the article. All authors read and approved the final version of the article.AcknowledgementsThe authors would like to thank Professor Ateş Duman for his invaluable assistance with editing and language editing.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eThe authors would like to thank Professor Ateş Duman for his invaluable assistance with editing and language editing.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eAll data is provided within the manuscript\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eBlair SN, Nichaman MZ. The public health problem of increasing prevalence rates of obesity and what should be done about it. Mayo Clin Proc. 2002;77(2):109\u0026thinsp;\u0026ndash;\u0026thinsp;13. doi: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.4065/77.2.109\u003c/span\u003e\u003cspan address=\"10.4065/77.2.109\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eNedelcut S, Axer S, Olbers T. The risk and benefit of revisional vs. primary metabolic- bariatric surgery and drug therapy - A narrative review. 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Transversus abdominis plane block for postoperative analgesia after caesarean delivery: a systematic review and meta-analysis. Br J Anaesth 2013;111:440\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eStewart MD, Johnson T, Evans W, Harkness H. Bilateral erector spinae plane blocks versus bilateral transversus abdominis plane blocks in patients undergoing abdominal surgery: a systematic review and meta-analysis. AANA J 2023;91:133\u0026ndash;40.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eElshazly M, El-Wahab NAA, Mostafa M. Erector spinae versus transversus abdominis plane block for postoperative analgesia after laparoscopic bariatric surgery: a randomized controlled trial. Ain-Shams J Anaesthesiol 2022;14:37.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Obesity, Bariatric Surgery, Pain, Erector Spinae Plane Block, Transversus Abdominis Plane Block","lastPublishedDoi":"10.21203/rs.3.rs-7113354/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7113354/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackgroundː \u003c/strong\u003eObesity is a major global health concern, and bariatric surgery is a widely used treatment. Postoperative pain management in these patients is challenging due to comorbidities limiting opioid use. Regional anesthesia techniques such as the transversus abdominis plane (TAP) block and erector spinae plane (ESP) block are key components of multimodal analgesia. The TAP block targets the abdominal wall but may offer limited visceral pain relief. The ESP block, a newer method, allows for broader analgesia and may be easier to administer in obese patients. This study compared the postoperative analgesic efficacy and feasibility of TAP and ESP blocks in laparoscopic bariatric surgery.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethodsː \u003c/strong\u003eIn this retrospective review, 64 adult patients (ASA III, BMI 40–60 kg/m²) who underwent elective laparoscopic sleeve gastrectomy received either a TAP block (n=30) or an ESP block (n=34). Data on demographics, pain scores (VAS), time to first analgesic requirement, patient satisfaction, and adverse events were collected. The primary outcome was the mean VAS score within 24 hours postoperatively.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResultsː\u003c/strong\u003e Baseline characteristics were similar. Both techniques were safe and well tolerated. The ESP group had significantly lower VAS scores at the 2nd postoperative hour (p=0.028), but differences diminished thereafter. Patient satisfaction was high in both groups (96.9%).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusionsː\u003c/strong\u003e TAP and ESP blocks both provided effective, opioid-sparing analgesia with minimal complications. The ESP block may offer procedural advantages in obese patients. The choice between techniques can be guided by patient-specific factors and practitioner expertise. Further prospective studies are needed to explore long-term outcomes.\u003c/p\u003e","manuscriptTitle":"Comparison of the effects of erector spinae plane and transversus abdominis plane blocks on postoperative pain in obesity surgery ESP vs TAP for Postoperative Pain in Bariatric Surgery","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-31 12:25:19","doi":"10.21203/rs.3.rs-7113354/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"1e634ba5-4a5c-4307-86be-8621a1f454aa","owner":[],"postedDate":"July 31st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-12-08T20:53:34+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-31 12:25:19","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7113354","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7113354","identity":"rs-7113354","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}