A Rectus Sheath Block in Open Hysterectomy.

Area of Science:

• Anesthesiology
• Surgical Pain Management
• Regional Anesthesia

Background:

• Open gynecological surgeries like hysterectomy cause significant postoperative pain, necessitating effective analgesia.
• Rectus sheath block (RSB) targets anterior abdominal wall sensory nerves, providing pain relief for lower abdominal surgeries.
• RSB is associated with reduced opioid use and fewer adverse effects during the perioperative period.

Purpose of the Study:

• To evaluate the efficacy of bilateral Ultrasound (US)-guided RSB in managing postoperative pain after transabdominal open hysterectomy.

Main Methods:

• A prospective randomized study involving 70 female patients undergoing elective open hysterectomy.
• Patients were divided into two groups: a control group (standard general anesthesia) and a test group (US-guided RSB with ropivacaine plus standard general anesthesia).
• Postoperative pain was assessed using the Visual Analogue Scale (VAS), with secondary outcomes including opioid consumption and recovery metrics.

Main Results:

• The RSB group (Group 2) demonstrated significantly lower VAS pain scores at all measured time points compared to the control group (Group 1).
• Intraoperative opioid consumption, time to first bowel motility, and time to discharge from bed were reduced in the RSB group.
• Patients receiving RSB experienced shorter post-anesthesia care unit discharge times and reported higher satisfaction.

Conclusions:

• Bilateral Ultrasound-guided RSB is an effective analgesic technique for open hysterectomy.
• RSB improves pain control, reduces opioid requirements, and enhances recovery and patient satisfaction following open abdominal gynecological surgery.