Abdominal Hysterectomy, Pain, Postoperative Pain
Conditions
Brief summary
his study aims to investigate the effects of different volumes of ultrasound-guided erector spinae plane block (ESPB) on postoperative pain and opioid consumption in patients undergoing total abdominal hysterectomy. The researchers aim to determine whether varying the volume of local anesthetic in the ESPB can reduce the amount of morphine required by patients and improve pain scores during the first 24 hours after surgery.
Interventions
PROCEDUREErector Spinae Plane Block
The ESPB will be performed at the T8-T9 vertebral levels. Patients will be placed in the prone position, and skin preparation will be performed with 10% povidone-iodine. Local anesthesia of the skin and subcutaneous tissue will be provided with 3 ml of 2% lidocaine at the target injection site. Under ultrasound guidance, a sterile-covered linear probe (8 MHz) will be used to visualize the T8 spinous process in the horizontal plane at the midline. The probe will then be rotated to the longitudinal plane, approximately 3 cm lateral to the midline, to visualize the transverse process and the overlying erector spinae muscle. A 22-gauge, 80-mm block needle will be advanced in-plane in a cranio-caudal direction until it contacts the transverse process. The needle was then withdrawn slightly, and its placement between the erector spinae muscle and the transverse process was confirmed through hydrodissection. The patients in Group I received 20 ml of 0.25% (2.5 mg/ml) bupivacaine hydrochloride
Sponsors
Şule Arıcan
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Patients aged between 18 and 65 years. * Patients with American Society of Anesthesiologists (ASA) physical status I-III. * Patients scheduled to undergo elective total abdominal hysterectomy surgery.
Exclusion criteria
* Obese patients (Body Mass Index \> 30 kg/m²). * Patients with local skin infection at the site of needle insertion. * Patients with a known allergy to any of the medications used in the study. * Patients with coagulopathy. * Patients with chronic opioid consumption. * Patients with an inability to use the Patient-Controlled Analgesia (PCA) device. * Patients with advanced hepatic or renal failure. * Patients who refuse to participate in the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total Morphine Consumption | First 24 hours postoperatively | The total amount of morphine (in milligrams) consumed by the patient via the Patient-Controlled Analgesia (PCA) device. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Numerical Rating Scale (NRS) Scores for Pain | At postoperative 30 minutes, 2nd, 6th, 12th, and 24th hours | Pain intensity measured at rest and during movement (dynamic) using a scale from 0 (no pain) to 10 (worst possible pain). |
| Number of Blocked Dermatomes | 20 minutes after the block procedure | The number of dermatomes with loss of hot-cold sensation above and below the surgical incision. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORŞule Arıcan, Assoc. Prof.
Necmettin Erbakan University Faculty of Medicine, Department of Anesthesiology and Reanimation
PRINCIPAL_INVESTIGATORHasan Çekdemir, specialist
Hadim State Hospital, Department of Anesthesiology and Reanimation
Outcome results
None listed