Inclusion Criteria:  Patients were required to have a BMI ≥40 kg/m ASA physical status class 2 or 3.  Exclusion Criteria:  any complication (allergic reaction or local anesthesia-related complication) failure, or patient refusal during the block procedure switch to open surgery or a change in the planned surgical protocol analgesia nociception index (ANI) and/or bispectral index (BIS) monitoring not possible patient does not provide consent or withdraws consent at any point after inclusion.