Combination of Superior Hypogastric Plexus Block and Transversus Abdominis Plane Block in Abdominal Hysterectomies

Analgesic Effect of Combination of Superior Hypogastric Plexus Block and Transversus Abdominis Plane Block in Abdominal Hysterectomies: A Randomized Controlled Trial

This study aims to evaluate the analgesic effect of superior hypogastric plexus block combined with transversus abdominis plane block in abdominal hysterectomies.

Study Overview

• Status: Not yet recruiting
• Conditions: Transversus Abdominis Plane Block; Superior Hypogastric Plexus Block; Abdominal Hysterectomies
• Intervention / Treatment: Other: Superior hypogastric plexus block + Transverse abdominis plane; Other: Superior hypogastric plexus block

Detailed Description

Abdominal hysterectomy is a major surgery that is often associated with pronounced postsurgical pain. Inadequate postoperative analgesia can lead to postoperative complications and can delay functional recovery. Accordingly, a multimodal regimen for postoperative pain management is recommended.

The transverse abdominis plane (TAP) block is a regional block anesthetizing the nerves (T10 to L1) hence covering the lower abdominal wall.

The superior hypogastric plexus (SHP), which lies retroperitoneally in front of the L5 and S1 vertebrae, provides innervation to the pelvic viscera. The blockade of SHP is well-recognized for the management of chronic pelvic pain.

• Study Type: Interventional
• Enrollment (Estimated): 44
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Mohammed S Elsharkawy, MD; Phone Number: 00201148207870; Email: mselsharkawy@med.tanta.edu.eg

Study Locations

• Egypt
  • El-Gharbia
    • Tanta, El-Gharbia, Egypt, 31527
      • Tanta University
      • Contact: Mohammed S Elsharkawy, MD; Phone Number: 00201148207870; Email: mselsharkawy@med.tanta.edu.eg

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age ≥ 18 years.
• American Society of Anesthesiology (ASA) physical status I-II.
• Undergoing abdominal hysterectomies under general anesthesia (GA).

Exclusion Criteria:

• History of allergies to local anesthetics.
• Body mass index (BMI) >35 kg/m2.
• Opioid dependency.
• Cognitive impairment.
• Bleeding or coagulation disorders.
• Psychiatric and neurological disorder.
• Local infection at the site of injection.
• Severe heart, lung, liver, and renal dysfunction.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Group S; Patients will receive superior hypogastric plexus block (SHPB) using 20ml of bupivacaine 0.25%+ transverse abdominis plane (TAP) block using 20ml of bupivacaine 0.25%.	Other: Superior hypogastric plexus block + Transverse abdominis plane; Patients will receive superior hypogastric plexus block (SHPB) using 20ml of bupivacaine 0.25%+ transverse abdominis plane (TAP) block using 20ml of bupivacaine 0.25%.
Active Comparator: Group C; Patients will receive superior hypogastric plexus block (SHPB) using 20ml of saline 0.9% (sham)+ transverse abdominis plane (TAP) block using 20ml of bupivacaine 0.25%.	Other: Superior hypogastric plexus block; Patients will receive superior hypogastric plexus block (SHPB) using 20ml of saline 0.9% (sham)+ transverse abdominis plane (TAP) block using 20ml of bupivacaine 0.25%.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Time to the first request for the rescue analgesia	Time to the first request for the rescue analgesia will be recorded from the end of surgery to first dose of morphine administrated.	24 hours postoperatively

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Total morphine consumption	Rescue analgesia of morphine will be given as 3 mg bolus if the numeric rating scale (NRS) > 3 to be repeated after 30 min if pain persists until the NRS < 4.	24 hours postoperatively
Degree of pain	Each patient will be instructed about postoperative pain assessment with the numeric rating scale (NRS). NRS (0 represents "no pain" while 10 represents "the worst pain imaginable"). NRS will be assessed at post-anesthesia care unit (PACU), 2, 4, 6, 8, 12, 18, and 24 h postoperatively.	24 hours postoperatively
Incidence of adverse events	Incidence of adverse events such as bradycardia, hypotension, nausea, vomiting, respiratory depression, pruritus, or any other complication will be recorded.	24 hours postoperatively
Quality of recovery	The quality of recovery (QoR-15) score will be assessed 24 hours postoperatively. This tool consists of 15 questions, each scored on a 10-point scale, yielding a maximum of 150. It encompasses five domains; physical comfort (questions 1-4, 13), emotional state (questions 9, 10, 14, 15), psychological support (questions 6, 7), physical independence (questions 5, 8), and pain (questions 11, 12).	24 hours postoperatively

Collaborators and Investigators

• Sponsor: Tanta University

Study record dates

Study Major Dates

• Study Start (Estimated): May 25, 2026
• Primary Completion (Estimated): October 1, 2026
• Study Completion (Estimated): October 1, 2026

Study Registration Dates

• First Submitted: May 19, 2026
• First Submitted That Met QC Criteria: May 19, 2026
• First Posted (Actual): May 26, 2026

Study Record Updates

• Last Update Posted (Actual): May 26, 2026
• Last Update Submitted That Met QC Criteria: May 19, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: 36265PR2/4/26

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
• IPD Sharing Time Frame: After the end of study for one year.
• IPD Sharing Access Criteria: The data will be available upon a reasonable request from the corresponding author.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No