The intent of this study is to compare the efficacy of the erector spinae plane block (ESPB) and paravertebral plane block in reducing postoperative opioid consumption and pain in patients with total abdominal hysterectomy.
ASA I and ASA II patients.
Female, 30-60 years of age.
Scheduled for total abdominal hysterectomy.
Patient refusal of procedure or participation in the study.
Opioid or analgesic abuse.
Known allergy to study drug.
Local infection at the site of puncture.
Parallel
Paravertebral Plane Block
Procedure/SurgeryThe spinous process of the 10th thoracic vertebra will be located under the ultrasound guided (USG) linear probe. Under aseptic precautions, a 22-G short-beveled needle will be inserted under ultrasonographic guidance using the in-plane approach and was directed medially between the transverse process (TP) and the pleura. The needle will traverse the superior costotransverse ligament and enter the paravertebral space, where 2 ml of normal saline will be injected. The tip of the needle will be in the paravertebral space, noting the pleura being pushed down. Then, 20 ml of 0.25% bupivacaine will be injected into the paravertebral space under USG visualization.
Erector Spinea Plane Block
Procedure/SurgeryThe USG linear probe will be placed Longitudinal 3 cm lateral to T10 transverse process TP. A 22-G short-beveled needle will be inserted in the cephalad to caudal direction through the erector spinae to contact the T10 TP using the in-plane technique. After the needle made contact with TP, the plane will be confirmed by injecting 2ml of saline and depositing 20ml of 0.25% bupivacaine.
bupivicaine 0.25%
Drug20 ml of 0.25% bupivacaine will be injected
total morphine consumption
Postoperative total morphine requirements in the first 24 hours after surgery.
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