Traditionally, systemic opioids like intravenous tramadol have been employed for postoperative pain management in PCNL due to their centrally acting analgesic properties. However, opioid-based analgesia is not without drawbacks—it often brings along a host of undesirable side effects such as nausea, vomiting, sedation, respiratory depression, and delayed mobilization, which can hinder early recovery. In recent years, the quest for safer and more effective analgesic alternatives has led to increased interest in regional anesthesia techniques, especially interfascial plane blocks. Among these, the Erector Spinae Plane Block (ESPB), first described in 2016, has gained attention for its simplicity, safety profile, and ability to provide both somatic and visceral analgesia.  By depositing local anesthetic in the fascial plane deep to the erector spinae muscle at the level of the transverse process, ESPB facilitates diffusion of the drug to the dorsal and ventral rami of spinal nerves, thereby covering multiple dermatomes. Its application in PCNL has been explored due to the anatomical proximity of the surgical site to the thoracolumbar segments innervating the kidney.