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This randomized controlled clinical trial designed to evaluate the efficacy of transversus abdominis plane (TAP) block, intrathecal morphine, or their combination in postoperative pain relief, as assessed by time to first analgesic request, pain scores, total postoperative analgesic consumption, time of ambulation, complications and hemodynamics following total abdominal hysterectomy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TAP block | Active Comparator | Bilateral ultrasound-guided TAP block with 20 mL of 0.25% plain bupivacaine on each side of the abdomen at the end of surgery. |
|
| Intrathecal Morphine | Active Comparator | Intrathecal injection of 100 µg morphine plus 20 mg hyperbaric bupivacaine (in spinal anesthesia). |
|
| Combined | Active Comparator | Intrathecal injection of 50 µg morphine plus 20 mg hyperbaric bupivacaine combined with bilateral ultrasound-guided TAP block using 20 mL of 0.25% plain bupivacaine on each side of the abdomen at the end of surgery. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| TAP Block | Procedure | The transabdominal plane (TAP) block is a regional anesthesia technique used for postoperative pain management in abdominal wall procedures, providing somatic analgesia to the anterior and lateral abdominal walls |
| Measure | Description | Time Frame |
|---|---|---|
| Time to first analgesic request | Time (in hours) until the patient demand additional analgesia. | 24 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Total analgesic consumption | Cumulative postoperative analgesic consumption | 24 hours |
| Time to ambulation | Time (in hours) from arrival in the PACU until the patient was able to walk. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| sohair Adeeb, assist.prof. | Minia University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of Medicine, Minia University | Minya | Minya Governorate | 61111 | Egypt |
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| ID | Term |
|---|---|
| D000775 | Anesthesia, Spinal |
| ID | Term |
|---|---|
| D000765 | Anesthesia, Conduction |
| D000758 | Anesthesia |
| D000760 | Anesthesia and Analgesia |
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| Intrathecal morphine injection | Drug | Intrathecal injection of morphine plus 20 mg hyperbaric bupivacaine in spinal anesthesia |
|
| spinal anesthesia | Drug | intrathecal injection of bupivacaine |
|
| 24 hours |
| complications | Incidence of nausea, vomiting, pruritus, respiratory depression, hematoma, infection or hemodynamic instability | 24 hours |