NCT06954896

Comparison of Superior Hypogastric Plexus Block and Peritoneal Bupivacaine in Pain Management

Comparison of Superior Hypogastric Plexus Block and Peritoneal Bupivacaine in Pain Management After Laparoscopic Hysterectomy

• Status: Completed
• Phase: —
• Study type: Observational
• Enrollment: 94 (actual)
• Sponsor: Enes Celik · Academic / Other
• Sex: Female
• Age: 18 Years – 65 Years
• Healthy volunteers: Not accepted

Summary

Background: Laparoscopic hysterectomy is one of the most frequently performed major surgeries in nonmalignant gynecological diseases. Effective postoperative analgesia is associated with short hospital stays, early mobilization, reduced costs, and patient satisfaction. Intravenous administration of nonsteroidal anti-inflammatory drugs, paracetamol or opioids; epidural catheter placement; peritoneal local anaesthetic administration; and superior hypogastric plexus block (SHPB) are routinely employed methods for postoperative pain management following laparoscopic hysterectomy. Methods: The study population comprised patients who underwent laparoscopic hysterectomy with or without oophorectomy for benign indications. A total of 94 patients were included in the study. Thirty patients received a superior hypogastric plexus block, thirty received intraperitoneal local anaesthetic spray, and thirty-four received intravenous analgesics. Conclusion: In the present study, a comparison of postoperative pain management in patients who underwent laparoscopic hysterectomy was conducted.

Detailed description

In the present study, a comparison of postoperative pain management in patients who underwent laparoscopic hysterectomy was conducted. The findings indicated that the initial postoperative administration of analgesics occurred later in patients who received peritoneal local anesthetics and SHPB compared to the control group. In addition, VAS values at the first and third hours were found to be lower in the peritoneal local anesthetic and SHPB groups than in the control group. Postoperative pain experienced by patients following gynecologic surgery. It has been reported that approximately 75% of patients experience severe pain. Excessive opioid use in postoperative pain management and the potential for additional complications are also possible. One of the alternative methods to reduce postoperative opioid use is intraperitoneal bupivacaine administration.

Conditions

• Superior Hypogastric Plexus Block
• Intraperitoneal Bupivacaine

Interventions

Type	Name	Description
DRUG	Bupivacain	The superior hypogastric plexus block (SHPB) was performed following uterine removal and closure of the vaginal cuff, but prior to trocar removal from the abdominal cavity. The promontory was identified under laparoscopic visualization. The posterior peritoneum overlying the promontory was gently grasped and elevated with an instrument to create a peritoneal tent. A needle was then inserted at the apex of the tent and advanced approximately 1 cm. At this point, a subperitoneal space was further expanded using a surgical instrument, and 30 ml of 0.25% bupivacaine was injected into the area
DRUG	Dexketoprofen (KETAVEL 50 mg/2 ml)	In cases where the VAS score exceeded 3 in the postoperative period, it was deemed that the patient's analgesia was insufficient, prompting the intravenous administration of 50 mg of dexketoprofen sodium.
DRUG	Intraperitoneal Bupivacaine spray	The peritoneal cavity and abdominal wall were treated with 30 milliliters of 0.25% bupivacaine, with a focus on areas involving the peritoneum in the lower abdominal region.

Timeline

• Start date: 2024-07-01
• Primary completion: 2024-12-30
• Completion: 2025-02-20
• First posted: 2025-05-02
• Last updated: 2025-05-02

Locations

1 site across 1 country: Turkey (Türkiye)