Ultrasound Guided Rectus Sheath Block Versus Intrathecal Morphine for Postoperative Analgesia in Patients Undergoing Open Total Abdominal Hysterectomy

Ain Shams University

Status: Enrolling

Conditions: Postoperative Analgesia; Intrathecal Morphine; Rectus Sheath Block; Total Abdominal Hysterectomy; Ultrasound

Treatments: Drug: Rectus sheath block; Drug: Intrathecal morphine

Study type: Interventional

Funder types: Other

Identifiers

NCT06837506

FMASU R03/2024/2025

Details and patient eligibility

About

This study aims to compare the effectiveness and safety of ultrasound-guided rectus sheath block versus intrathecal morphine for postoperative analgesia in patients undergoing open total abdominal hysterectomy.

Full description

Effective postoperative analgesia is crucial for enhancing recovery and patient satisfaction following major surgical procedures, such as total abdominal hysterectomy (TAH).

Rectus sheath block (RSB), an ultrasound-guided regional anesthesia technique, involves the injection of local anesthetic into the rectus sheath, providing analgesia to the anterior abdominal wall. RSB is used to block the sensory nerves of the anterior abdominal wall and thereby contributing to pain relief after lower abdominal surgeries.

Intrathecal morphine (ITM) provides a highly effective method of analgesia by delivering the medication directly into the cerebrospinal fluid (CSF).

Enrollment: 80 estimated patients

Sex: Female

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age: 18 - 65 years old.
• American Society of Anesthesiologists (ASA) physical status (I -II).
• Patients undergoing open total abdominal hysterectomy.

Exclusion criteria

• Hepatic, renal, or cardiac disease.
• Any known allergy to local anesthetic.
• Physical or mental conditions which may vague measuring 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

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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80 participants in 2 patient groups

Rectus sheath block group

Experimental group

Description:

Patients will receive rectus sheath block (20 ml bilaterally, bupivacaine 0.25%) after induction of general anesthesia.

Treatment:

Drug: Rectus sheath block

Intrathecal morphine group

Experimental group

Description:

Patients will receive 150 µg intrathecal morphine after induction of general anesthesia.

Treatment:

Drug: Intrathecal morphine