Effect of the rectus sheath block on hemodynamic changes in totalabdominal hysterectomy as a part of multimodal anestesia

Background:Total abdominal hysterectomy (TAH) is associated with substantial postoperative pain and discomfort. Rectus sheath block (RSB) is used to block the sensory nerves of the anterior abdominal wall and thereby contributetopain relief after lower abdominal surgeries. Aim of Study:The aim of this study is to evaluate the effect of bilateral Ultrasound (US)-guided RSBon hemodynamic changes after TAH. Patients and Methods:This prospective randomized study was carried out on 10 females, ASA I or II,presented for elective TAH undergeneral anesthesia (GA) and randomly classified into 2 equal groupsR and C of5 patientseach; patients in Group R received RSBwith 40 ml ropivacaine 0.375% (20ml each side) before surgery and standard endotracheal anesthesia and patients in Group C received only standard general endotracheal anesthesia. Mean arterial Blood pressure (MAP)and Heart rate (HR) were measured as baseline, after induction of GA, every 15 min till end of surgery, immediately after recovery, at 6h, 12h and 24 h postoperatively.Conclusion:Patients in group R with bilateral US-guided RSB and standard general anesthesia had at the start and during the hysterectomy higher values of systolic and diastolic pressure, mean arterial blood pressure and heart rate, compared to the control group C which had a calm hemodynamic initial course, while themeasuredpostoperative values showed stable parameters and a certain decrease in the values of the hemodynamic parameters in the control group R compare to the patients in the group C,showing an approximation to the values of the parameters of group C. Keywords: hemodynamic changes, Rectus Sheath Block, Total Abdominal Hysterectomy