after laparoscopic bariatric surgery, visceral pain (VP) remains a significant issue. VP causes autonomic symptoms, such as nausea and vomiting, and does not respond to conventional pain management methods that target incisional pain. The present study was performed to test the effect of use of combined paragastric autonomic neural blockade and laparoscopic assisted transversus abdominis plane block on visceral pain during laparoscopic bariatric surgery and in the early postoperative period.
Age: 20-50 years, both sexes.
ASA physical status class I to III.
BMI 35- 50 kg/m²
Severe cardiac disorder
chronic renal failure
liver cirrhosis
allergy to bupivacaine