Combination of Superior Hypogastric Plexus Block and Transversus Abdominis Plane Block in Abdominal Hysterectomies

Analgesic Effect of Combination of Superior Hypogastric Plexus Block and Transversus Abdominis Plane Block in Abdominal Hysterectomies: A Randomized Controlled Trial

This study aims to evaluate the analgesic effect of superior hypogastric plexus block combined with transversus abdominis plane block in abdominal hysterectomies.

Abdominal hysterectomy is a major surgery that is often associated with pronounced postsurgical pain. Inadequate postoperative analgesia can lead to postoperative complications and can delay functional recovery. Accordingly, a multimodal regimen for postoperative pain management is recommended.

The transverse abdominis plane (TAP) block is a regional block anesthetizing the nerves (T10 to L1) hence covering the lower abdominal wall.

The superior hypogastric plexus (SHP), which lies retroperitoneally in front of the L5 and S1 vertebrae, provides innervation to the pelvic viscera. The blockade of SHP is well-recognized for the management of chronic pelvic pain.

Inclusion Criteria:

• Age ≥ 18 years.
• American Society of Anesthesiology (ASA) physical status I-II.
• Undergoing abdominal hysterectomies under general anesthesia (GA).

Exclusion Criteria:

• History of allergies to local anesthetics.
• Body mass index (BMI) >35 kg/m2.
• Opioid dependency.
• Cognitive impairment.
• Bleeding or coagulation disorders.
• Psychiatric and neurological disorder.
• Local infection at the site of injection.
• Severe heart, lung, liver, and renal dysfunction.