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September 5, 2025Open Access

The opioid-sparing effect of intraoperative superior hypogastric plexus block after total abdominal hysterectomy: A randomized controlled trial

Key Points

Patients receiving superior hypogastric plexus block reported significantly lower postoperative pain scores.
Postoperative morphine consumption was reduced to 24.03 mg in the SHPB group compared to 34.24 mg in the placebo group.
The time to first analgesic request was longer in the group treated with bupivacaine, indicating better pain management.
Patients in the SHPB group experienced fewer instances of nausea and vomiting compared to those receiving placebo.

Abstract

Abstract Background: Postoperative pain is a common concern for patients undergoing total abdominal hysterectomy (TAH). A significant amount of opioid analgesic is typically necessary to effectively manage pain after a TAH, despite the potential for experiencing side effects. Therefore, the use of any technique that will provide an opioid-sparing effect is highly desirable. This research investigated the postoperative opioid-sparing effects of superior hypogastric plexus block (SHPB) with bupivacaine versus a placebo in patients undergoing TAH. Materials and Methods: A randomized, double-blinded, placebo-controlled study was conducted over nine months. Fifty-four consenting participants were randomized into Groups A and B to receive SHPB with bupivacaine or saline, respectively. The opioid-sparing effect was determined by the total postoperative morphine consumption in 24 h in both groups. The analysis of data was conducted using version 23.0 of the Statistical Package for the Social Sciences (IBM-SPSS). Results: Patient ages in the study ranged from 35 to 65 years. The average age of participants in both Group A (51.70 ± 9.37) and Group B (51.89 ± 9.68) was comparable, with a P value of 0.943. Group A showed significantly lower postoperative pain scores, as measured by the visual analog scale, at the post-anesthesia care unit and at 1, 2, and 4 h ( P < 0.05). Group A demonstrated a prolonged time to the first analgesic request compared with the control group ( P < 0.001). Postoperative morphine consumption was significantly lower in Group A, with a mean consumption of 24.03 ± 2.83 mg, compared with 34.24 ± 4.67 mg in Group B ( P < 0.001). In Group A, eight (29.6%) patients had nausea, while 17 patients (63.0%) had nausea in Group B ( P = 0.028). In Group A, four patients (14.8%) experienced vomiting, while in Group B, 14 patients (51.9%) experienced vomiting. The patients in both groups were comparable in the incidence of pruritus ( P = 1.000). The complications related to SHPB or bupivacaine were not recorded in this study. Conclusion: The study showed that intraoperative SHPB using bupivacaine provided a better opioid-sparing effect when compared with a placebo.

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Cite This Study

Abdullahi et al. (Thu,) studied this question.

synapsesocial.com/papers/68bb3edf2b87ece8dc956cdd https://doi.org/https://doi.org/10.4103/amsr.amsr_46_23

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