The Effectiveness of Superior Hypogastric Plexus Block with Bupivacaine for Pain Relief after Total Abdominal Hysterectomy: A Randomized Controlled Study

Abstract

Background: Postoperative pain is a major concern after total abdominal hysterectomy (TAH). We suggest that the use of intraoperative superior hypogastric plexus block (SHPB) could be a viable and safe alternative for managing postoperative pain in patients who have undergone TAH. Materials and Methods: After receiving ethical approval, 54 patients who were scheduled for TAH were divided equally into two groups: Group A and Group B. Following the procedure, patients in Group A (n = 27) were injected with 20 ml of 0.25% bupivacaine, whereas patients in Group B (n = 27) were injected with 20 ml of 0.9% saline into the superior hypogastric plexus’s (SHPs) anatomical position. After the surgery and recovery from anesthesia, all patients were administered intravenous morphine at a dosage of 0.1 mg/kg for postoperative pain relief. The Visual Analog Pain Scale was used to evaluate the postoperative pain. The quantity of morphine consumed within 24 h was also recorded. The data collected from the study were analyzed using IBM SPSS version 23.0. Results: The pain score measured in the postanesthesia care unit and at 1, 2, and 4 h after surgery was significantly lower in Group A when compared to Group B, with P < 0.05. There were no significant differences observed in the Visual Analog Scale scores at 12 and 24 h postsurgery between the two groups, with P > 0.05. The amount of morphine consumed in the 24 h following surgery was found to be significantly lower in Group A when compared to Group B. This difference was statistically significant, with P < 0.001. Conclusion: Intraoperative SHPB block after abdominal hysterectomy provides effective postoperative analgesia and reduces postoperative morphine consumption compared to placebo, with fewer incidences of opioid adverse effects.