Comparison of the Effects of Blocks on Postoperative Analgesia in Total Laparoscopic Hysterectomy Surgery
NCT ID: NCT07078643
Last Updated: 2025-07-24
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
NA
90 participants
INTERVENTIONAL
2022-03-01
2023-03-31
Brief Summary
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Detailed Description
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Following ethics committee approval (2022/514/220/10), the study was conducted between March 2022 and March 2023. Patients aged 18 to 65 years, classified as ASA physical status I-II and scheduled for elective TLH, were enrolled. Participants were randomly assigned into three groups using computer-generated randomization (n=30 per group): SHPB, ESPB, and Control. Both the anesthesiologist performing postoperative evaluations and the patients were blinded to group allocation.
All patients received general anesthesia in accordance with a standardized protocol.
ESPB was performed bilaterally at the T10 level under ultrasound guidance. SHPB was performed laparoscopically at the L5-S1 level after uterine removal. No regional block was applied in the control group.
Postoperative pain management was provided to all patients via patient-controlled analgesia (PCA). Pain levels were evaluated using the Visual Analog Scale (VAS) at postoperative 0, 30, 60, 90, and 120 minutes, and at 6, 12, and 24 hours.
This study aims to investigate whether SHPB provides more effective visceral analgesia compared to ESPB and whether this leads to reduced opioid requirements and improved patient satisfaction following TLH.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
TRIPLE
Study Groups
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Superior Hypogastric Plexus Block (SHPB) Group
SHPB Group: In this group, patients received a superior hypogastric plexus block (SHPB) following total laparoscopic hysterectomy. After uterus removal and vaginal cuff closure, and before trocar removal, the injection site was identified laparoscopically. The block was performed in all patients by a single surgeon experienced in SHPB.
Superior Hypogastric Plexus Block (SHPB)
Laparoscopic superior hypogastric plexus block with bupivacaine and lidocaine injection near sacral promontory.
Erector Spinae Plane Block Group
ESPB Group: Patients in this group received erector spinae plane block (ESPB) during anesthesia maintenance after surgery. Patients were positioned in the lateral decubitus position. At the T10 level, the ultrasound probe was placed in the midline to identify spinous processes, then moved 2-3 cm laterally to visualize the transverse process, trapezius, and erector spinae muscles. The same procedure was performed on the opposite side. All blocks were performed by a single anesthesiologist experienced in ESPB.
Erector Spinae Plane Block (ESPB)
Erector spinae plane block with ultrasound-guided injection of bupivacaine and lidocaine at T10 level.
Control Group
Control Group: Patients in this group did not receive any block and were managed with standard postoperative care only. This group served as the comparison group to evaluate the effects of the block interventions.
No interventions assigned to this group
Interventions
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Superior Hypogastric Plexus Block (SHPB)
Laparoscopic superior hypogastric plexus block with bupivacaine and lidocaine injection near sacral promontory.
Erector Spinae Plane Block (ESPB)
Erector spinae plane block with ultrasound-guided injection of bupivacaine and lidocaine at T10 level.
Eligibility Criteria
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Inclusion Criteria
* Scheduled for elective total laparoscopic hysterectomy (TLH)
* Classified as American Society of Anesthesiologists (ASA) physical status I or II
* Able to provide written informed consent in accordance with the Declaration of Helsinki
Exclusion Criteria
* Body mass index (BMI) ≥ 35 kg/m²
* Inability to cooperate or follow instructions
* Presence of spinal or paravertebral deformity
* Known coagulopathy or use of anticoagulant therapy
* Known hypersensitivity or allergy to local anesthetic drugs used in the study
* Requirement for postoperative intensive care
* History of chronic opioid use (longer than four weeks prior to surgery)
18 Years
65 Years
FEMALE
No
Sponsors
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Dr. Lutfi Kirdar Kartal Training and Research Hospital
OTHER_GOV
Responsible Party
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MACİD ORDU
Assistant Doctor
Principal Investigators
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Macid Ordu, MD
Role: PRINCIPAL_INVESTIGATOR
Kartal Dr. Lütfi Kırdar Training and Research Hospital
Locations
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Kartal Dr. Lütfi Kırdar Training and Research Hospital
Istanbul, , Turkey (Türkiye)
Countries
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Other Identifiers
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DrLutfiKirdarTRH-MO-01
Identifier Type: -
Identifier Source: org_study_id
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