Procedure: Modified thoracoabdominal nerve block through perichondrial approach (M-TAPA)

transversus abdominis, internal oblique, and external oblique muscles will be identified
with a high-frequency (10 MHz) linear probe on the costochondral angle in the sagittal
plane under ultrasound guidance at the 10th costal margin. A deep angle was given to the
costochondral angle at the edge of the 10th costal margin with the probe in the sagittal
direction to view the lower surface of the costal cartilage in the midline. A 22-G,
100-mm block needle will be inserted in the cranial direction using the in-plane
technique and the needle tip will be moved to the posterior aspect of the 10th costal
cartilage. It is noted that the needle tip never crossed the cranial edge of the 10th
costal cartilage
Other Name: (M-TAPA)

Procedure: Quadratus lumborum block

using ultrasound guidance (Sonosite turbo M, Bothell, Washington, USA) and a curved
ultrasound probe (2.5-7.5 MHz). The probe will be placed in the mid-axillary line between
the lower costal margin and the iliac crest in a transverse plane to view all abdominal
layers. The probe will be moved towards the posterior axillary line, to reach a point
where all three abdominal muscle layers merge to form aponeurosis.

The aponeurosis will then be followed dorsally until the quadratus lumborum muscle is
seen deep to transversalis fascia with its attachment to the transverse process of the L4
vertebral body. A 22 G, 100 mm, blunt, insulated nerve block needle will be inserted 1 cm
medial to the probe and advanced using the in-plane technique with ultrasound real-time
assessment. The injection site will be the junction of transversalis fascia and the
anterolateral border of quadratus lumborum muscle
Other Name: (QLB)