Adequate postoperative analgesia is difficult to achieve in patients undergoing laparoscopic sleeve gastrectomy (LSG). Epidural anesthesia is technically difficult due to subcutaneous fat, which increases the risk of serious complications. Moreover, patients in this condition often have comorbidities that require anticoagulation therapy. Although ultrasound-guided Transversus Abdominis Plane (TAP) block may be useful, it is still controversial.

Recently, modified thoracoabdominal nerve block via perichondrial approach (M-TAPA) has been reported as a new and promising technique that provides effective analgesia in the anterior and lateral thoracoabdominal wall.

The most common reason for hospitalization after laparoscopic surgery is pain after nausea and vomiting. In addition, superficial and tachypneic breathing resulting from the patient's inability to breathe deeply with pain causes closure of small airways and increase in intrapulmonary shunts, resulting in hypoxia. Postoperative pain management is important not only to prevent pain but also to reduce pulmonary complications that may occur due to changes in lung function and to reduce mortality and morbidity by controlling the stress response.

In this study, The investigators investigated the effect of modified thoracoabdominal nerve block via perichondrial approach (M-TAPA) on pulmonary function in patients undergoing laparoscopic bariatric surgery under general anesthesia.

Inclusion Criteria:

• Between 18-65 years old

  • ASA I-II-III risk group
  • Patients whose approval was obtained through an informed consent form
  • Will undergo laparoscopic bariatric surgery
  • Patients who will cooperate for the PFT test

Exclusion Criteria:

• <18 years and >65 years

  • ASA ≥ IV
  • 50% below the expected value in SFT
  • Known diaphragmatic paralysis
  • Having had a myocardial infarction within 1 month
  • Dementia or confusion
  • Lack of cooperation
  • Those with respiratory disease
  • Congestive heart failure
  • Unstable hypertension
  • Had thoracoabdominal surgery

Patients aged 18-65 who will undergo ASA I-III laparoscopic bariatric surgery