Effect of Superficial Cervical Plexus Block on Post Operative Nausea and Vomiting in Tympanomastoid Operations

Inclusion Criteria: * Patients belonging to American Society of Anesthesiologists physical status I-II. * operation time less than 4 hours. Exclusion Criteria: * • American Society of Anesthesiology (ASA) physical status ≥ III. * Uncooperative or mentally retarded patients. * Known Allergy or hypersensitivity to lidocaine or bupivacaine. * Patients known to have gastritis or Gastro-oesophageal reflux disease (GERD). * History of PONV or motion sickness. * Operation duration (short less than 30 minutes or prolonged more than 240 min). * Patients with chronic renal disease (serum creatinine level ≥2.0mg/dl) or on renal replacement therapy (dialysis). * Patients with chronic cholecystitis (history of recurrent or persistent vomiting) * Skin inflammation and cellulitis.