Abdominal Hysterectomy
Conditions
Keywords
abdominal hysterectomy, intratechal morphine, transversalis fascia plane block
Brief summary
Hysterectomy is one of the most commonly performed surgical procedures after cesarean section in many countries worldwide, especially among women of reproductive age. Postoperative pain is typically managed with oral and parenteral narcotics. Patient-controlled analgesia (PCA) is an effective pain management method that provides advantages such as faster pain relief, better dosage control, and elimination of the need for timer adjustments. Facilitating the recovery process and optimizing postoperative pain management are crucial components of perioperative care. To minimize systemic opioid requirements and opioid-related side effects, multimodal analgesia combining local anesthesia, peripheral, and non-opioid analgesics has become increasingly popular.
Interventions
OTHERIntratechal Morphine
Prior to induction, the patient will be positioned seated, and morphine will be slowly injected intrathecally at a dose of 5 μg/kg, adjusted to the L4-L5 or L3-L4 intervertebral space using a 27G pencil point spinal needle. The injection will be administered over approximately 10 seconds
Prior to induction, patients will be positioned supine, and bilateral transversus abdominis plane (TAP) block will be performed with the aid of ultrasound. As the blocking agent, 20 cc of 0.25% bupivacaine will be used bilaterally.
Sponsors
Ataturk Training and Research Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Women aged between 18 and 65 years classified as ASA 1 and ASA 2.
Exclusion criteria
* Patients with allergies to the active substance, those with severe liver or renal insufficiency, a history of long-term nonsteroidal anti-inflammatory drug (NSAID) and opioid analgesic use, a history of gastrointestinal bleeding, peptic ulcer or inflammatory bowel disease, a history of diabetes or other neuropathic conditions, preoperative atrioventricular block and bradycardia, underlying serious respiratory diseases, a history of psychiatric disorders, patients classified as ASA stage 3 or higher, patients weighing less than 40 kg, patients unable to use the patient-controlled analgesia (PCA) device, and patients who need to discontinue the study medication during surgery for any reason will be excluded from the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperatve Opioid Consumption | postoperatively 24 hours | The primary aim of this study is to compare the analgesic efficacy of intrathecal morphine and bilateral transversalis fascia plane block in patients undergoing elective abdominal hysterectomy, in terms of morphine consumption during the first 24 hours postoperatively |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Quality of recovery 24 hours after the surgery assessed using QoR-40 questionnaire | postoperative 24 hour | Evaluation of quality of recovery 24 hours after the surgery assessed using QoR-40 questionnaire |
| Advers Event | postoperative 24 hour | incidence of side effects (nause, vomiting, urinary retention) for 24 hours |
| Postoperative Pain Scores at movement and rest | postoperatively 24 hours | evaluation of pain scores during movement and rest within 24 hours postoperatively using Visual Analogue Scale |
Countries
Turkey (Türkiye)
Contacts
Primary ContactEmirhan Akarsu
Outcome results
None listed