Comparison Between Erector Spinae Plane Block and Transversus Abdominis Plane Block on Postoperative Analgesia After Total Abdominal Hysterectomy

Study Overview
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Brief Summary
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This study aims to compare the ultrasound-guided bilateral erector spinae block versus the ultrasound-guided bilateral transversus abdominis plane block on postoperative analgesia after total abdominal hysterectomy.

Official Title
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Comparative Study Between Bilateral Ultrasound-Guided Erector Spinae Plane Block Versus Bilateral Ultrasound-Guided Transversus Abdominis Plane Block on Postoperative Analgesia After Total Abdominal Hysterectomy

Conditions
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Uterine Diseases

Intervention / Treatment
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* Procedure: erector spinae plane block
* Procedure: transversus abdominis plane block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients American Society of Anesthesiologists physical status (ASA) I and II. Female sex. Age between 40 to 60 years old. Scheduled for elective total abdominal hysterectomy surgeries. Exclusion Criteria: Patient's refusal. Patients who received long-acting opioids preoperatively. Patients with bleeding disorders and coagulopathy. Infection at the injection site. Allergy to local anesthetics. Patients with significant cognitive dysfunction. Patients with diabetic neuropathy. Patients with uncontrolled hypertension or diabetes. Patients with advanced cardiac, respiratory, hepatic or renal disease. Patients with viral hepatitis or HIV. Surgeries which have been complicated or prolonged (more than 150 mins).

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Group A : erector spinae block.<br>patients will receive bilateral ultrasound guided erector spinae block. | Procedure: erector spinae plane block<br>* Patients will receive ESB. In the lateral decubitus, after skin sterilization, ESP block will be performed at the level of T9<br>|
| Experimental: Group B : transversus abdominis plane block.<br>patients will receive bilateral ultrasound guided transversus abdominis plane block. | Procedure: transversus abdominis plane block<br>* patients will receive TAP block in supine position after skin sterilization, TAP block will be performed between internal oblique and transversus abdominis muscles<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total morphine consumption | Compare postoperative pain intensity using the total amount of morphine consumption in the first 24 hours after the operation, and the time for first call rescue analgesia | 24 hours postoperative | 
| Visual Analog Scale Score | Compare postoperative pain intensity using VAS score in the first 24 hours after the operation.The VAS score is a 10-cm line labeled with worst pain imaginable on the right border, and no pain on the left border (ranging from 0 by indicating no pain to 10 indicating extreme pain). | 24 hours postoperative | 
| The time for first call rescue analgesia | the time for first call rescue analgesia | 24 hours postoperative | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient satisfaction | Measure patient satisfaction by asking the patient if he is satisfied or not yes or no | 24 hours postoperative | 
| Recognize the adverse effects | Recognize the adverse effects | 24 hours postoperative | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ESPB, TAP