Gynecology
Conditions
Brief summary
40 patients who are consenting to be recruited in the study and are fulfilling the eligibility criteria will be subjected to: Group A Before the removal of uterus and the closure of vaginal cuff, insertion of 6inch 22G needle 2 to 3 cm below the umbilicus, 30 ml normal saline (sodium chloride solution 0.9%, FIPCO, Egypt)will be administered. While patients randomized to group B will undergo TLH with pre-sacral nerve block.
Detailed description
40 patients who are consenting to be recruited in the study and are fulfilling the eligibility criteria will be subjected to: Group A Before the removal of uterus and the closure of vaginal cuff, insertion of 6inch 22G needle 2 to 3 cm below the umbilicus, 30 ml normal saline (sodium chloride solution 0.9%, FIPCO, Egypt)will be administered , then the uterus will be removed, and the operation will be terminated While patients randomized to group B will undergo TLH with pre-sacral nerve block as follows: Uterosacral nerve block will be performed before the removal of uterus and the closure of vaginal cuff, and before the removal of trocars from abdominal cavity, insertion of 6-inch 22G needle 2 to 3 cm below the umbilicus, injection of the SHP area which situated anterior to L5-S1 vertebral bodies, Caudal to the bifurcation of the abdominal aorta with 30 ml 0.25% bupivacaine (Marcaine®0.25% , Astra Zeneca, Egypt) will be administered. Following the injection of local anesthetic, patient will be placed from Trendelenburg position to horizontal position. The we will remove the uterus and trocars , and the operation will be terminated. Data will be recorded in a case report form (CRF) and statistical analysis will be done.
Interventions
pre-sacral nerve block (bupivacaine injection into both uterosacral ligaments at the end of laparoscopic hysterectomy.
Sponsors
Study design
Eligibility
Inclusion criteria
* Women undergoing elective total laparoscopic hysterectomy Body mass index less than 29 Kg/m2
Exclusion criteria
* Previous presacral neurectomy * Concurrent surgical procedure other than salpingectomy and/or oophorectomy * Chronic narcotic consumption Inability to provide consent * Patients with contraindication to laparoscopic surgery (e.g. severe cardiopulmonary dysfunction). * Bleeding tendency (e.g. patient on anticoagulants, platelets disorders) * Intra-abdominal adhesions (due to previous abdominal surgery e.g. myomectomy)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| ● Post-operative pain 1 hour after the procedure will be assessed by visual analogue scale (VAS). (range will be from zero (no pain) to 10 | 1hour | ● Post-operative pain 1 hour after the procedure will be assessed by visual analogue scale (VAS). (range will be from zero (no pain) to 10 |
Countries
Egypt