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Total abdominal hysterectomy (TAH) is a major surgical procedure after which significant post-operative pain and discomfort are anticipated. Abdominal field blocks have been followed for many years and extensively used for pain management following abdominal surgeries such as laparotomies and appendicectomies. Erector Spinae Plane Block (ESPB)-first recently described for the treatment of thoracic neuropathic pain, is a peri-paravertebral regional anesthesia technique that has since been reported as an effective technique for prevention of postoperative pain in various surgeries. Intrathecal opioid administration is an attractive analgesic technique since the opioid is injected directly into the cerebrospinal fluid, close to the structures of the central nervous system where the opioid acts.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| G1 Group: (Erector Spinae Plane Block (ESPB) Group) | Active Comparator |
| |
| G2 Group: (Intra thecal morphine (ITM) Group) | Active Comparator |
| |
| G3 Group: (Control Group) | Other |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ultrasound Guided Erector Spinae Plane Block | Procedure | General anesthesia using intravenous fentanyl (1µgm/kg) and patients will receive bilateral ultrasound-guided ESPB by the an experienced anesthetist in US regional blocks, with each block 20 mL of bupivacaine 0.25% |
| Measure | Description | Time Frame |
|---|---|---|
| The time for requirement of first rescue analgesic (min) | The time for requirement of first rescue analgesic (min) | 24 hours postoperatively |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ain-Shams University Hospitals | Cairo | Egypt |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40047853 | Derived | Ashoor TM, Esmat IM, Algendy MA, Mohamed NR, Talaat SM, Rabie AH, Elsayed AM. Comparison of the postoperative analgesic efficacy of the ultrasound-guided erector spinae plane block and intrathecal morphine in patients undergoing total abdominal hysterectomy under general anesthesia: a randomized controlled trial. J Anesth. 2025 Apr;39(2):299-310. doi: 10.1007/s00540-025-03466-1. Epub 2025 Mar 6. |
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| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
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| Intra thecal morphine. | Drug | General anesthesia using intravenous fentanyl (1µgm/kg) and patients will receive intra thecal morphine with spinal needle 25G, 3 ml containing 300 ug preservative free morphine |
|
| General anesthesia using intravenous fentanyl (1µgm/kg) | Drug | Patients will receive general anesthesia using intravenous fentanyl (1µgm/kg) |
|
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |