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Ultrasound Guided Versus Surgical Rectus Sheath Block Versus Local Anesthesia Infiltration for Postoperative Analgesia in Patients Undergoing Total Abdominal Hysterectomy

ConditionsUltrasoundSurgicalRectus Sheath BlockLocal Anesthesia InfiltrationPostoperative AnalgesiaTotal Abdominal Hysterectomy
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexFemale
Age18-65
SponsorAin Shams University

About this trial

The aim of this work is to compare the efficacy and safety of the effectiveness and safety of ultrasound-guided surgical rectus sheath block and local anesthetic infiltration for postoperative analgesia in patients undergoing total abdominal hysterectomy.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Age from 18 to 65 years old.

American Society of Anesthesiologists (ASA) physical status I - II.

Patients scheduled for elective total abdominal hysterectomy under general anesthesia.

Disqualifiers

Hepatic, renal or cardiac disease.

Any known allergy to local anesthetic.

Physical or mental conditions which may vaguely measure postoperative pain following surgery.

History of chronic use of analgesic as nonsteroidal anti-inflammatory drugs (NSAIDs) or central nervous system (CNS) depressants as antiepileptic, and bleeding disorders.

Trial design

Design model

Parallel

Treatments tested in this trial

  • Ultrasound-guided rectus sheath block

    Drug

    Patients will receive ultrasound-guided rectus sheath block (20 ml bupivacaine 0.25%) bilaterally at the end of surgery.

  • Surgical rectus sheath block

    Drug

    Patients will receive a surgical rectus sheath block (20 ml bupivacaine 0.25%) bilaterally at the time of closure.

  • Local anesthesia infiltration

    Drug

    Patients will receive local anesthesia infiltration at the end of surgery.

Treatment groups

90 Participants
are divided into 3 treatment groups
Group A: Ultrasound-guided rectus sheath block groupExperimental treatment 1 intervention
Group B: Surgical rectus sheath block groupExperimental treatment 1 intervention
Group C: Local anesthesia infiltration groupExperimental treatment 1 intervention

Trial outcomes

Primary outcomes

1

Total morphine consumption

Rescue analgesia of morphine will be given as 3 mg bolus if the Visual Analogue Scale (VAS)\> 3 to be repeated after 30 min if pain persists until the VAS \< 4.

Time frame
24 hours postoperatively

Secondary outcomes

1

Heart rate

Heart rate will be recorded preoperatively, before the block is performed, and every 15 minutes until the end of the surgery.

Time frame
Till the end of surgery (Up to 4 hours)
2

Mean arterial pressure

Mean arterial pressure will be recorded preoperative, before performing of block, and every 15 min till the end of surgery.

Time frame
Till the end of surgery (Up to 4 hours)
3

Time to the first request for the rescue analgesia

Time to the first request for the rescue analgesia (time from end of surgery to first dose of morphine administrated).

Time frame
24 hours postoperatively
4

Degree of pain

Each patient will be instructed about postoperative pain assessment with the Visual Analogue Scale (VAS). VAS (0 represents "no pain" while 10 represents "the worst pain imaginable"). VAS will be assessed at PACU, 2, 4, 6, 12, 18, and 24h postoperatively.

Time frame
24 hours postoperatively

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Ain Shams University

Lead sponsor

Source ClinicalTrials.gov
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