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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group Intratechal Morphine | Active Comparator |
| |
| Group Transversalis Fascia Plane Block | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Intratechal Morphine | Other | 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 |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperatve Opioid Consumption | 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 | postoperatively 24 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative Pain Scores at movement and rest | evaluation of pain scores during movement and rest within 24 hours postoperatively using Visual Analogue Scale | postoperatively 24 hours |
| Quality of recovery 24 hours after the surgery assessed using QoR-40 questionnaire |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Emirhan Akarsu | Contact | +90 535 283 28 97 | emirhanakarsu@gmail.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ataturk University | Recruiting | Erzurum | Yakutiye | 25100 | Turkey (Türkiye) |
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| Transversalis Fascia Plane Block | Other | 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. |
|
Evaluation of quality of recovery 24 hours after the surgery assessed using QoR-40 questionnaire |
| postoperative 24 hour |
| Advers Event | incidence of side effects (nause, vomiting, urinary retention) for 24 hours | postoperative 24 hour |