The effect of subcutaneous in trocar site and intraperitoneal and posterior transverses abdominis plan block under laparoscopic guide with bupivacaine on post laparoscopic pain in laparoscopic hysterectomy

Comparison of subcutaneous injection at the trocar site, intraperitoneal injection and transverse abdominis plan block under laparoscopic guidance with bupivacaine 0.25% in reducing abdominal pain and shoulder pain after laparoscopic hysterectomy.

A phase 3 randomized controlled double-blinded clinical trial, with parallel groups, of 95 patients. For randomization, the block randomization method and STATA software will be used.

The study is conducted in a double-blind manner, in such a way that none of the patients and the pain evaluator know about the method of analgesia after laparoscopic hysterectomy surgery, and as a result, the study is conducted in a double-blind manner.Abdominal and shoulder pain score using VISUAL-ANALOGUE-SCALE during the first 2-4 hours after surgery. 8 hours. It is measured 12 hours and 24 hours after surgery. Scoring is done with the help of nurses in the post-surgery department without their knowledge of the applied anesthesia method. Complications after surgery. The amount of drug use. The amount of Morphin and Ketorolac ampoules used. Nausea and vomiting after surgery are recorded.

All patients who are candidates for elective laparoscopic hysterectomy referred to Arash Hospital who have a good general health level based on ASA Grade 1&2 and are candidates for hysterectomy due to benign disease. Patients suffering from chronic pelvic pain, pregnancy, sensitivity to bupivacaine, emergency surgery, cancer are excluded from the study.

The three intervention groups: subcutaneous injection of bupivacaine 0.25%, intraperitoneal injection and posterior transverse abdominis block, and the control group.

Abdominal pain; shoulder pain; need for narcotics; need for painkillers; nausea and vomiting decrease after laparoscopic hysterectomy.

For the randomization process, the balance block randomization method is used using STATA software. To ensure that the randomization process of people in the groups remains hidden, the randomized sequence is kept with one of the project researchers, who is part of the selection team. Patients and carrying out the intervention process and evaluating the outcome are not.

For the randomization process, the balance block randomization method is used using STATA software. To ensure that the randomization process of people in the groups remains hidden, the randomized sequence is kept with one of the project researchers, who is part of the selection team. Patients and carrying out the intervention process and evaluating the outcome are not. The study is conducted in a double-blind manner, in such a way that none of the patients and the pain evaluator know about the method of analgesia after laparoscopic hysterectomy surgery. Analgesia is injected by laparoscopic fellowship doctors half an hour before the end of anesthesia induction. Procedure selection envelopes are with the operator of the operating room, and one envelope is randomly delivered to the laparoscopic fellowship for anesthesia.