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Purpose <p>Total abdominal hysterectomy (TAH) is a common surgical procedure. Erector spinae plane block (ESPB) and intrathecal morphine (ITM) provide adequate postoperative (PO) analgesia. However, ITM side effects may limit its use. Researchers investigated the efficacy of bilateral ultrasound-guided ESPB on PO pain and analgesic consumption compared to ITM in the first 24 h following TAH under general anesthesia.</p> Methods <p>120 patients premedicated with 3 mg intravenous granisetron were randomized into three equal groups: bilateral ultrasound-guided ESPB, ITM or control group. The primary outcome of this study was the time to first request for a rescue analgesic (tramadol).</p> Results <p>Compared to the control group, the ESPB and ITM groups showed higher time to first request for a rescue analgesic and lower total tramadol consumption 24&#xa0;h following surgery (<i>P</i> &lt; 0.001) with significant differences between the ESPB and ITM groups (<i>P</i> &lt; 0.001). The ITM group showed lower pain scores and lower readings of both serum glucose and cortisol levels compared to the other two groups 24&#xa0;h after surgery (<i>P</i> &lt; 0.001). The ITM group also had higher incidences of nausea and pruritus 24 h after surgery (<i>P</i> &lt; 0.001)<b>.</b> The use of a single intrathecal injection of 0.3 mg morphine did not show any respiratory depression.</p> Conclusion <p>0.3 mg intrathecal morphine was superior to erector spinae plane block for postoperative pain relief, 24 h after surgery, regarding attenuated stress response, lower pain scores at rest and on coughing and lower tramadol consumption.</p> IRB <p>IRB 00006379//31-1-2022.</p> Trial registration number <p>ClinicalTrials.gov Identifier: NCT05218733.</p>

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Comparison of the postoperative analgesic efficacy of the ultrasound-guided erector spinae plane block and intrathecal morphine in patients undergoing total abdominal hysterectomy under general anesthesia: a randomized controlled trial

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年3月6日

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  • Tarek Mohamed Ashoor,
  • Ibrahim Mamdouh Esmat,
  • Mohammad Abdalsalam Algendy,
  • Noha Refaat Mohamed,
  • Sahar Mohamed Talaat,
  • Amal Hamed Rabie,
  • Ahmed Mohammed Elsayed

摘要

Purpose

Total abdominal hysterectomy (TAH) is a common surgical procedure. Erector spinae plane block (ESPB) and intrathecal morphine (ITM) provide adequate postoperative (PO) analgesia. However, ITM side effects may limit its use. Researchers investigated the efficacy of bilateral ultrasound-guided ESPB on PO pain and analgesic consumption compared to ITM in the first 24 h following TAH under general anesthesia.

Methods

120 patients premedicated with 3 mg intravenous granisetron were randomized into three equal groups: bilateral ultrasound-guided ESPB, ITM or control group. The primary outcome of this study was the time to first request for a rescue analgesic (tramadol).

Results

Compared to the control group, the ESPB and ITM groups showed higher time to first request for a rescue analgesic and lower total tramadol consumption 24 h following surgery (P < 0.001) with significant differences between the ESPB and ITM groups (P < 0.001). The ITM group showed lower pain scores and lower readings of both serum glucose and cortisol levels compared to the other two groups 24 h after surgery (P < 0.001). The ITM group also had higher incidences of nausea and pruritus 24 h after surgery (P < 0.001). The use of a single intrathecal injection of 0.3 mg morphine did not show any respiratory depression.

Conclusion

0.3 mg intrathecal morphine was superior to erector spinae plane block for postoperative pain relief, 24 h after surgery, regarding attenuated stress response, lower pain scores at rest and on coughing and lower tramadol consumption.

IRB

IRB 00006379//31-1-2022.

Trial registration number

ClinicalTrials.gov Identifier: NCT05218733.