Transversus Abdominus Plane (TAP) block may reduce need for postoperative pain medications in patients undergoing laparoscopic hand assisted nephrectomy. Our hypothesis is that the TAP block will result in a significant reduction in pain scores and morphine requirements in the active group.

Inclusion Criteria:

• Patients who are ≥ 18 and ≤ 80 years of age.
• Patients scheduled to undergo hand assisted laparoscopic removal of a single kidney for either tumor or living donor transplantation.

Exclusion Criteria:

• Patients scheduled to undergo an open procedure for nephrectomy
• Patients who are converted from hand assisted laparoscopic surgery to open surgery due to intraoperative complications.
• Bilateral nephrectomy
• Pregnant or lactating patients
• Patients unable or unwilling to provide informed consent
• Patients unable to comprehend the use of a visual analog scale
• Patients desiring preemptive antiemetics
• Opioid tolerance
• Allergy to amide local anesthetics or any of the study drugs (morphine).
• Contraindication to regional nerve block (bleeding disorder, infection at site of block)
• Patients with history of dementia