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

NCT06954896 | Completed

• 1 other identifier: ArtukluU-MED-EC-01
• Study Type: observational
• Target: 94
• Locations: 1 country
• Sites: 1

Brief 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.

Conditions

Superior Hypogastric Plexus Block; Intraperitoneal Bupivacaine

Keywords

Hypogastric Plexus; Hysterectomy; Intraperitoneal Injections

Outcome Measures

Primary Outcomes (1)

• VAS (vısual analog scale)

  For patients with no pain, VAS was recorded as 0 (zero), and for those with unbearable pain, VAS was recorded as 10 (ten).

  24 HOUR

Study Arms (3)

intraperitoneal local anaesthetic spray (Group B)

Drug: Intraperitoneal Bupivacaine spray

intravenous analgesics (Group C)

Drug: Dexketoprofen (KETAVEL 50 mg/2 ml)

superior hypogastric plexus block (Group S)

Drug: Bupivacain

Interventions

Bupivacain DRUG

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

superior hypogastric plexus block (Group S)

Dexketoprofen (KETAVEL 50 mg/2 ml) DRUG

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.

intravenous analgesics (Group C)

Intraperitoneal Bupivacaine spray DRUG

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.

intraperitoneal local anaesthetic spray (Group B)

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

The study population comprised patients who underwent laparoscopic hysterectomy-with or without oophorectomy-for benign indications (such as myoma uteri, dysfunctional uterine bleeding, uterine prolapse, or precancerous cervical lesions) between July 2024 and December 2024, and who were classified as ASA physical status I-II. Patients were excluded if they were younger than 18 or older than 65, underwent epidural catheterisation and/or received additional pain management modalities (e.g., transversus abdominis plane block, local wound infiltration, quadratus lumborum block), had surgery for malignancy, underwent a different surgical approach (e.g., transvaginal natural orifice transluminal endoscopic surgery), or were prescribed preoperative antidepressants or gabapentinoids.

You may qualify if:

• patients who underwent laparoscopic hysterectomy-with or without oophorectomy-
• ASA physical status I-II patients

You may not qualify if:

• women with known bupivacaine allergy, anxiety-depressive disorders, fibromyalgia, coagulopathy, eclampsia/preeclampsia, or those who were pregnant were also excluded.
• if they were younger than 18 or older than 65
• underwent epidural catheterisation and/or received additional pain management modalities
• prescribed preoperative antidepressants or gabapentinoids

Sponsors & Collaborators

• Enes Celik: lead

Study Sites (1)

Mardin Artuklu University

Mardin, Turkey (Türkiye)

Location

MeSH Terms

Interventions

Bupivacaine; dexketoprofen trometamol

Intervention Hierarchy (Ancestors)

Anilides; Amides; Organic Chemicals; Aniline Compounds; Amines

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Anesthesiologist

Study Record Dates

• First Submitted: April 14, 2025
• First Posted: May 2, 2025
• Study Start: July 1, 2024
• Primary Completion: December 30, 2024
• Study Completion: February 20, 2025
• Last Updated: May 2, 2025

Record last verified: 2025-04

Locations

TU (1)