Major abdominal surgeries are traditionally performed via laparotomy. Analgesia is routinely administered during the postoperative period. The goal is to investigate the effects of laparotomy and analgesia methods on diaphragm function.

Laparotomy is typically performed through a midline incision during major abdominal surgeries. Patients have difficulty breathing deeply after surgery, particularly because of pain. Intravenous drug administration, epidural catheter placement, and abdominal plane blocks are common methods of analgesia. In this study, the investigators will measure the diaphragm muscle thickness at the xiphoid level at the anterior axillary line in the supine position in participants who underwent laparotomy before and one hour after the operation, using ultrasonography M mode during inspiration, expiration, and forced inspiration. the investigators will test the effects of analgesia methods on diaphragm contraction in participants undergoing laparotomy.

Inclusion Criteria:

• over 18 years,
• major abdominal surgery cases

Exclusion Criteria:

• body mass index (BMI) >35 kg/m2
• illiteracy,
• communication issues,
• neuromuscular disorders,
• Advanced chronic respiratory disease,
• Previous abdominal or thoracic surgery

Patients scheduled for major abdominal surgery due to gastrointestinal tumor