COMPARISON OF DURATION OF POST OPERATIVE ANALGESIA IN PATIENTS UNDERGOING TOTAL ABDOMINAL HYSTERECTOMY WITH ULTRASOUND GUIDED BILATERAL ERECTOR SPINAE PLANE BLOCK VERSUS BILATERAL TRANSVERSUS ABDOMINIS PLANE BLOCK

Abstract

Background: Hysterectomy is one of the most commonly performed gynecological surgeries worldwide. Effective postoperative analgesia is crucial to enhance recovery and reduce complications. Ultrasound-guided Erector Spinae Plane (ESP) and Transversus Abdominis Plane (TAP) blocks are two regional anesthesia techniques increasingly used for postoperative pain management. Objective: To compare the mean duration of postoperative analgesia in patients undergoing total abdominal hysterectomy with bilateral ultrasound-guided ESP block versus TAP block. Methods: This randomized controlled trial was conducted at the Department of Anesthesia, Sir Ganga Ram Hospital, Lahore, over six months from 1st December 2024 to 31st May 2025. Sixty patients undergoing elective total abdominal hysterectomy were enrolled and randomized into two groups of 30 each. Group A received bilateral ESP blocks, while Group B received bilateral TAP blocks, both under ultrasound guidance. The primary outcome was the mean duration of postoperative analgesia, defined using the Visual Analogue Scale (VAS), with scores ≤3 indicating effective analgesia. Results: The mean duration of postoperative analgesia was significantly higher in the ESP group compared to the TAP group (p < 0.001). No major adverse events were observed in either group. Conclusion: Ultrasound-guided ESP block provides superior postoperative analgesia compared to TAP block in patients undergoing total abdominal hysterectomy, supporting its use as a preferred regional anesthesia technique.