Ultrasound Guided Versus Surgical Rectus Sheath Block Versus Local Anesthesia Infiltration for Postoperative Analgesia in Patients Undergoing Total Abdominal Hysterectomy

Ain Shams University

Status: Enrolling

Conditions: Postoperative Analgesia; Local Anesthesia Infiltration; Rectus Sheath Block; Total Abdominal Hysterectomy; Surgical; Ultrasound

Treatments: Drug: Surgical rectus sheath block; Drug: Local anesthesia infiltration; Drug: Ultrasound-guided rectus sheath block

Study type: Interventional

Funder types: Other

Identifiers

NCT06837532

FMASU R23/2025

Details and patient eligibility

About

The aim of this work is to compare the efficacy and safety of the effectiveness and safety of ultrasound-guided surgical rectus sheath block and local anesthetic infiltration for postoperative analgesia in patients undergoing total abdominal hysterectomy.

Full description

Total abdominal hysterectomy (TAH) is a commonly performed major surgical procedure that results in substantial postoperative pain and discomfort.

Local anesthetic infiltration (LAI) at the end of surgery is one of the most common technique employed in laparotomies for postoperative analgesia.

Rectus sheath block (RSB) has been used as a part of multimodal analgesia, especially when neuraxial techniques are unsuitable.The RSB was used to achieve peri-operative relaxation of the anterior abdominal wall.

Enrollment: 90 estimated patients

Sex: Female

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age from 18 to 65 years old.
• American Society of Anesthesiologists (ASA) physical status I - II.
• Patients scheduled for elective total abdominal hysterectomy under general anesthesia.

Exclusion criteria

• Hepatic, renal or cardiac disease.
• Any known allergy to local anesthetic.
• Physical or mental conditions which may vaguely measure 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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90 participants in 3 patient groups

Ultrasound-guided rectus sheath block group

Experimental group

Description:

Patients will receive ultrasound-guided rectus sheath block (20 ml bupivacaine 0.25%) bilaterally at the end of surgery.

Treatment:

Drug: Ultrasound-guided rectus sheath block

Surgical rectus sheath block group

Experimental group

Description:

Patients will receive a surgical rectus sheath block (20 ml bupivacaine 0.25%) bilaterally at the time of closure.

Treatment:

Drug: Surgical rectus sheath block

Local anesthesia infiltration group

Experimental group

Description:

Patients will receive local anesthesia infiltration at the end of surgery.

Treatment:

Drug: Local anesthesia infiltration