This single-center retrospective cohort study evaluated the effect of the modified thoracoabdominal nerves block through a perichondrial approach (M-TAPA) on postoperative analgesia in patients undergoing elective total laparoscopic hysterectomy. Medical records of 60 patients who underwent surgery at Tekirdag Namik Kemal University Faculty of Medicine Hospital between December 25, 2023 and December 25, 2024 were retrospectively reviewed. Patients who received bilateral ultrasound-guided M-TAPA block were compared with patients who received standard general anesthesia and systemic analgesia without M-TAPA block. The primary outcome was cumulative tramadol consumption during the first 24 postoperative hours. Secondary outcomes included postoperative Visual Analog Scale (VAS) pain scores at predefined time points, rescue analgesic requirements, postoperative nausea and vomiting, Quality of Recovery-15 (QoR-15) scores, and block-related complications.