This prospective, randomized, double-blind study aimed to compare the effects of ultrasound-guided versus laparoscopy-guided transversus abdominis plane(TAP) block on postoperative analgesia in patients undergoing laparoscopic upper abdominal surgery under general anesthesia. Postoperative pain scores, analgesic consumption and recovery parameters were evaluated during the first 24 hours after surgery.

Patients aged 18-70 years with ASA physical status I-III who were scheduled for laparoscopic upper abdominal surgery under general anesthesia were included in the study. After induction of anesthesia, patients were randomly assigned to one of two group, bilateral subcostal transversus abdominis plane block was performed under ultrasound-guidance using a local anesthetic mixture before extubation. In the laparoscopy-guided group, bilateral subcostal transversus abdominis plane block was performed under laparoscopic guidance using the same local anesthetic mixture before abdominal closure. Postoperative pain intensity was assessed by using the Numeric Rating Scale (NRS). Total opioid consumption, time to first analgesic requirement, paracetamol consumption, postoperative nausea and vomiting, length of hospital stay, time to ambulation and time to gastrointestinal recovery were recorded during the first 24 hours after surgery. Complications related to the TAP block were also evaluated.

Inclusion Criteria:

• Patients aged 18-70 yeras
• ASA physical status I-III
• Scheduled for laparoscopic upper abdominal surgery
• Provided written informed consent

Exclusion Criteria:

• Patient refusal
• Allergy to local anesthetics
• Coagulopathy
• Infection at the injection site
• Severe systemic disease
• ASA physical status IV-V