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NCT Number: NCT07480499

Erector Spinae Plane Versus Quadratus Lumborum Blocks for Pain Management After Total Abdominal Hysterectomy

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.

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Key information

Conditions

Post Operative Analgesia

Age range

35 year–65 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

About this study

Patients who met the inclusion criteria were recruited in the trial after getting approval from the Hospital Ethical Review Committee and REU CPSP. Demographic information such as age, height, weight, body mass index as well as the functional classification (ASA) was documented on a pre-made proforma. Patients were randomized into two groups using a computer-generated randomisation process.

Group A: Received an ultrasound-guided erector spinae plane block at the T9-T10 level using 20 ml of 0.25% bupivacaine.

Group B: Received an ultrasound-guided posterior quadratus lumborum block using 20 ml of 0.25% bupivacaine.

A qualified anaesthesiologist performed each block in aseptic settings prior to surgery. Standardised general anaesthesia was administered to each patient. The Visual Analogue Scale (VAS) was used to quantify pain at rest and on coughing at 2, 6, 12, 18, and 24 hours. Patents with VAS score more than 4, were given rescue analgesia and the cumulative amount of analgesics used in the first 24 hours as well as the time of the first rescue analgesia were recorded. Patient satisfaction with pain treatment as well as adverse effects such nausea, vomiting, and hypotension were tracked for a duration of 24 hours after the surgery

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Patients aged 35-60 years. ASA physical status I or II. Elective Total Abdominal Hysterectomy under General Anesthesia.

Exclusion criteria

Allergy with local anesthetics. Infection in the injection site. Coagulopathy or anticoagulant use. Morbid obesity (BMI > 35 kg/m²).

Treatment and study plan

Erector Spinae Plane Block

Procedure

Ultrasound-guided erector spinae plane block at the T9-T10 level using 20 ml of 0.25% bupivacaine.

Quadratus Lumborum Block (QLB)

Procedure

Ultrasound-guided posterior quadratus lumborum block using 20 ml of 0.25% bupivacaine.

Primary outcomes

  1. Post Operative Pain

    Time frame: 24 Hours

    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.

Secondary outcomes

  1. Time to first Rescue Analgesia

    Time frame: 24 Hourse

    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.

  2. Cumulative Opioid consumption

    Time frame: 24 Hours

    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.

  3. Adverse effects

    Time frame: 24 Hours

    Unwanted and unpleasant effects like nausea, vomiting during 24 hours post operatively

  4. Patient Satisfaction

    Time frame: 24 Hours

    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

Study contacts

Contact information is provided by the study sponsor or research team.

Hamid Altaf Altaf

CONTACT

[email protected]

+92 341 4764956

Sponsors and collaborators

Lead sponsor

Sheikh Khalifa Bin Zayed Al Nahyan Combined Military Hospital Muzaffarabad

Other

Registry information

Official study title

Comparative Efficacy of Erector Spinae Plane and Quadratus Lumborum Blocks in Managing Postoperative Pain for Total Abdominal Hysterectomy: A Randomized Controlled Trial

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Mar 18, 2026
Registry last updated
Mar 18, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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