Erector spinae block for abdominal hysterectomy

Good postoperative analgesia can prevent morbidity associated with abdominal hysterectomy by allowing pain-free, early ambulation, and decreasing the risks of long hospital stay, thromboembolism, and other poor outcomes. Regional anesthesia techniques offer good pain relief, reduce perioperative opioid and anesthetic use, reduces postoperative nausea and vomiting, helps in reducing chronic pain, and facilitates early rehabilitation. The erector spinae plane block (ESPB) is a newly defined regional anesthesia technique for thoracic analgesia. Its use for other indications, such as abdominal and thoracic surgery, has also recently been reported. In this technique, the local anesthetic injection is performed beneath the erector spinae muscle. Local anesthetic expected to achieve paravertebral spread of three vertebral levels cranially and four levels caudally. The injected local anesthetic traverses the costotransverse foramina and blocks ventral rami, dorsal rami of spinal nerves, and rami communicates that gives the sympathetic fibers. We hypothesize that ESPB will be effective for perioperative analgesia in patients undergoing abdominal hysterectomy. our aim is to improve outcomes after abdominal hysterectomy surgeries by adding the newly introduced erector spinae plane block as an adjuvant for general anesthesia.