Ultrasound-Guided Midpoint Transverse Process to Pleura Block Versus Erector Spinae Plane Block for Postoperative Analgesia in Patients Undergoing Open Renal Surgery :A Randomized Comparative Study.

The goal of this randomized comparative clinical trial is to compare the analgesic effectiveness of ultrasound-guided Midpoint Transverse Process to Pleura (MTP) block versus Erector Spinae Plane (ESP) block in adult patients undergoing open renal surgery. The main question it aims to answer is: Does MTP block provide postoperative analgesia comparable to ESP block, as assessed by postoperative opioid consumption and pain scores? Researchers will compare MTP block with ESP block to evaluate postoperative opioid consumption, pain intensity, time to first rescue analgesia, and the incidence of adverse events. Participants will receive general anesthesia followed by either ultrasound-guided MTP block or ESP block before surgery. Postoperative pain and opioid consumption will be assessed for 24 hours after surgery.

Inclusion Criteria: * ASA physical status I-II * BMI 20-35 * age between 18-65 years * will have open renal surgery (open stone kidney or nephrectomy ) Exclusion Criteria: * Patient refusal * Any allergy or contraindications to any of the study drugs. * Pain or chronic analgesic administration in the preoperative period. * Patients with coagulopathy or emergency surgery * Infection at local needle site of insertion. * Sever cardiac ,respiratory or liver diseases