The routine use of peripheral nerve blocks and wound infiltration with long-acting local anesthetics as an adjuvant to local, regional and general anesthetic techniques can improve postoperative pain management after a wide variety of surgical procedures. multimodal analgesia which is achieved by combining different analgesics that act by different mechanisms and at different sites in the nervous system, resulting in additive or synergistic analgesia with lowered adverse effects of sole administration of individual analgesics,is needed for acute postoperative pain management due to adverse effects of opioid analgesics, which can impede recovery; yet, the literature on multimodal analgesia often shows variable degrees of success, even with studies utilizing the same adjuvant medication.