Clinical Research Directory

Inclusion Criteria: * Adult patients aged 18 to 75 years * Scheduled for elective orthotopic liver transplantation (living or deceased donor) * J-shaped or Mercedes incision planned * ASA physical status III-IV * Normal or acceptable coagulation profile at the time of block application (INR ≤ 1.5, platelet count ≥ 50,000/mm³, fibrinogen ≥ 150 mg/dL) * Able to provide written informed consent Exclusion Criteria: * Coagulopathy at the time of block application (INR \> 1.5, platelet count \< 50,000/mm³, or fibrinogen \< 150 mg/dL) * Known allergy or hypersensitivity to local anesthetics (amide group) * Local infection or skin lesion at the block injection site * Severe hemodynamic instability requiring high-dose vasopressor support * Chronic opioid use (≥30 mg oral morphine equivalents per day for ≥30 days before surgery) * Severe hepatic encephalopathy or cognitive impairment preventing use of PCA or pain scoring * Emergency or re-transplantation surgery