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Comparison of Sensory Block Coverage and Clinical Effectiveness of TAP and Rectus Sheath Blocks in Pfannenstiel Incisions
Sponsor: Samsun University
Summary
Hysterectomy is one of the most common major gynecologic surgeries performed for various indications, and hundreds of thousands of procedures are carried out annually, particularly in developed countries. In total abdominal hysterectomies, the Pfannenstiel incision is frequently preferred due to its advantages in terms of aesthetics, functionality, and postoperative recovery. However, this incision can cause significant postoperative pain because of the extensive cutaneous innervation of the lower abdominal wall. This pain may delay early mobilization and negatively affect patient comfort and satisfaction. As part of multimodal analgesia strategies, regional anesthesia techniques are widely used in such surgeries to reduce opioid consumption and enhance analgesic efficacy. In this context, the Transversus Abdominis Plane (TAP) block and the Rectus Sheath Block (RSB) are among the effective techniques targeting the anterior abdominal wall, and various studies have investigated their spread patterns and clinical outcomes. However, data on the extent to which these blocks provide cutaneous sensory coverage of the Pfannenstiel incision remain limited, and direct comparative mapping studies are scarce in the literature. For patients undergoing hysterectomy, regional anesthesia techniques are commonly applied perioperatively either as a single technique or in combination for pain management, with TAP and RSB being the most frequently used modalities. In addition, patient-controlled analgesia (PCA) devices are routinely employed as a component of multimodal pain management in this population. The aim of this study is to comparatively evaluate the cutaneous sensory block areas produced by the TAP and RSB regional anesthesia techniques, their rates of coverage of the Pfannenstiel incision, and their clinical effectiveness.
Official title: Comparison of the Cutaneous Sensory Block Coverage of Surgical Incisions and Clinical Effectiveness of TAP and Rectus Sheath Blocks in Total Abdominal Hysterectomies Performed With a Pfannenstiel Incision: A Prospective Observational Study
Key Details
Gender
FEMALE
Age Range
18 Years - 70 Years
Study Type
OBSERVATIONAL
Enrollment
30
Start Date
2026-01-01
Completion Date
2027-07-01
Last Updated
2025-12-03
Healthy Volunteers
No
Conditions
Interventions
Group Transversus Abdominis Plane Block
Patients will receive a bilateral transversus abdominis plane block preoperatively under ultrasound guidance. Bilateral blocks will be performed using 0.25% bupivacaine (25 mL per side, total 50 mL). Sensory block areas will be evaluated using pinprick at predefined time points. Additionally, patients will be provided with a PCA device, and morphine consumption as well as NRS pain scores will be monitored at regular intervals.
Group Rectus Sheath Block
Patients will receive a bilateral rectus sheath block preoperatively under ultrasound guidance. Bilateral blocks will be performed using 0.25% bupivacaine (25 mL per side, total 50 mL). Sensory block areas will be evaluated using pinprick at predefined time points. Additionally, patients will be provided with a PCA device, and morphine consumption as well as NRS pain scores will be monitored at regular intervals.