TAH, being a large scale gynaecological operation, is a construction bound to cause serious postoperative pain to the patient in that the procedure will inevitably entail massive tissue dissection. Management of this postoperative pain is of utmost significance because poor analgesia may lead to delayed mobilization of the patient, long duration of hospitalization and also general increase in the morbidity of postoperative period. Traditionally, in these facilities, opioid analgesics are the most common and the most popular means of controlling postoperative pain. Nevertheless, the varied and pervasive use of opioids is largely constrained by its well-reported, dose-dependent systemic adverse effects. Nausea, vomiting, sedation, and respiratory depression are complications that severely degrade the recovery process of the patient and reduce his or her satisfaction.
None
None
Parallel
Erector Spinae Plane Block
Procedure/SurgeryUltrasound-guided erector spinae plane block at the T9-T10 level using 20 ml of 0.25% bupivacaine.
Quadratus Lumborum Block (QLB)
Procedure/SurgeryUltrasound-guided posterior quadratus lumborum block using 20 ml of 0.25% bupivacaine.
Post Operative Pain
Visual Analogue Score a one-dimensional indicator of pain severity. It is made up of a horizontal line that is 10 cm (100 mm) long and has two end points marked "No Pain" (0) and "Worst Possible Pain" (10). On the line, the patient marks the point that most accurately depicts their level of discomfort at 2,4,6,18 \& 24 hours post operatively.
Time to first Rescue Analgesia
When a patient's pain score surpasses a certain threshold (e.g., VAS \> 4), additional analgesic medication is administered when the primary anaesthetic approach is unable to give sufficient pain relief and the time will be calculated in hours.
Cumulative Opioid consumption
The total amount of opioid medicine needed by the patient over the course of the first 24 hours following surgery in order to sustain sufficient analgesia. This is frequently computed as the Morphine Equivalent Dose (mg) and standardised.
Adverse effects
Unwanted and unpleasant effects like nausea, vomiting during 24 hours post operatively
Patient Satisfaction
A conventional 5-point Likert scale that ranges from "Very Dissatisfied" to "Very Satisfied" is usually used to gauge the patient's subjective assessment of the level of pain care they got during 24 hours duration post-operatively
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