Abstract: Objective  To investigate the rehabilitation quality and safety of patients after different modes of nerve block under the concept of enhanced recovery (ERAS) in laparoscopic cholecystectomy (LC). 
Methods  A total of 85 patients who underwent LC in our hospital were selected and treated with LC. According to the postoperative nerve block mode, the patients were divided into T group (n=22), TR group (n=20), P group (n=21) and N group (n=22). T Group was given right lateral costal transverse abdominal muscle plane block (TAPB), TR group was given TAPB combined with right rectus abdominis sheath block (RSB), A group was given patient-controlled intravenous analgesia (PCIA), and N group was not given analgesic intervention. The differences in duration of operation, intraoperative bleeding, Ramsay sedation score (RSS) and visual analogue scale (VAS) score in each group were observed. 
Results  There was no significant difference in T group, TR group, P group and N group with respect to duration of operation, intraoperative bleeding and length of postoperative hospital stay (P＞0.05). The time of first exhaust and the first time of off-bed activity after operation in TR group were significantly lower than those in T group (P＜0.05), but there was no significant difference compared with P group (P＞0.05). There was no significant difference in RSS among the four groups in terms of interaction between groups, time points, time points between groups (P＞0.05). The VAS pain scores of the four groups were statistically significant in terms of interaction between groups, time points, and time points between groups. With the extension of time, the VAS pain scores of the four groups showed a downward trend (P＜0.05). At 24 h after operation, C reactive protein（CRP）, interleukin 6（IL-6）, cortisol（Cor） and E in the four groups were significantly better than those after operation, suggesting significant differences (P＜0.05). At 24 h after operation, CRP, IL-6, Cor and E in T group, TR group and P group were lower than those in N group, and CRP, IL-6, Cor and E in TR group were lower than those in T group at 24 h after operation, with no significant difference (P＜0.05). There was no significant difference between TR group and P group (P＞0.05). At 24 h after operation, CO and SV in the four groups were better than those after operation, and the difference was statistically significant (P＜0.05). At 24 h after operation, CO in T group, TR group and P group was higher than that in N group, while SV was lower than that in N group; CO in TR group was higher than that in T group, while SV was lower than that in T group, and the difference was statistically significant (P＜0.05); there was no significant difference between TR group and P group (P＞0.05). There was no significant difference in the interaction between groups, time points, and time points between groups with respect to the scores of the Mini-mental State Examination (MMSE) in the four groups (P＞0.05), but there was significant difference between time points. The MMSE score increased with time after surgery (P＜0.05). There was no significant difference among the four groups (P＞0.05). 
Conclusion  Under the concept of ERAS, the application of TAPB combined with RSB in LC surgery can effectively reduce postoperative pain and inflammatory stress response, with good safety, which is equivalent to the effect of postoperative PCIA. 

Key words: cholecystectomy, laparoscopic, enhanced recovery after surgery, nerve block