Evaluating the Combined Use of Intrathecal Morphine and Erector Spinae Plane Block for Pain Relief After Major Midline Abdominal Surgery

What this Trial Is About

Researchers are evaluating whether combining two pain-relief methodsthe Erector Spinae Plane Block ESPB, a peripheral nerve block, and Intrathecal Morphine ITM, a low-dose spinal medication injectionoffers better pain control after major midline abdominal surgery laparotomy in adults. The study aims to understand if this combination reduces pain and the amount of opioids needed within the first 48 hours after surgery. Participants are divided into three groups one receives only Intrathecal Morphine, another only the bilateral Erector Spinae Plane Block, and the third receives both treatments together before surgery. The ITM involves a single spinal injection of morphine at the lumbar level, while the ESPB is an ultrasound-guided injection of local anesthetic near the spine. The combination group receives both interventions sequentially before surgery. During the study, participants pain intensity at rest and during coughing, opioid use, and time to first rescue pain medication are closely monitored for 48 hours after surgery. Additional assessments include time to first movement, readiness for discharge from the post-anesthesia care unit, incidence of side effects, patient satisfaction with pain management, quality of recovery after one day, and healthcare use up to 30 days post-surgery. The total participation lasts from surgery through hospital discharge and follow-up assessments.

Efficacy of Adding Intrathecal Morphine to Erector Spinae Plane Block for Postoperative Analgesia After Midline Laparotomy