title: Ultrasound-Guided Rectus Sheath Block in Gynaecological Surgery with Pfannenstiel Incision.
abstract: OBJECTIVE
  This study aimed to evaluate the effects of ultrasound-guided rectus sheath block in gynaecological surgery with Pfannenstiel incision.
  
  
  METHODS
  After the approval of the ethics committee and the patients' consent, 75 ASA I-II patients who were aged between 20 and 70 years and scheduled for a gynaecological surgery with Pfannenstiel incision were included in this study. After induction of general anaesthesia, patients were randomly divided into three groups. In Group UR patients (n=25), ultrasound-guided rectus sheath block with 0.25% levobupivacaine (0.2 mL kg(-1)) was performed. In Group SR patients (n=25), surgical rectus sheath block with 0.25% levobupivacaine (0.2 mL kg(-1)) was applied. In Group T (n=25) patients, tramadol (2 mg kg(-1)) was intravenously administered 30 min before the end of surgery. Patient-controlled analgesia device was established for postoperative pain relief in all groups. Haemodynamic data and inspired sevoflurane concentration were recorded during the operation. Pain scores, total tramadol consumption, supplemental analgesic requirement and side effects were postoperatively evaluated.
  
  
  RESULTS
  Demographic characteristics, duration of surgery and haemodynamic parameters were similar between the groups. Inspired sevoflurane concentration (%) and VAS scores were significantly lower in Group UR than those in Groups SR and T. Total tramadol consumption was significantly lower in Groups UR and SR than that in Group T. There was no significant difference in the incidence of side effects.
  
  
  CONCLUSIONS
  This study demonstrates that ultrasound-guided rectus sheath block helps to provide the effective analgesia without any side effects compared with surgical rectus sheath block and intravenous tramadol for gynaecological surgery with Pfannenstiel incision.
authors.affiliation: Clinic of Anaesthesiology and Reanimation, Aşkım Tüfekçi State Hospital, Adana, Turkey.
authors.forename: Şule
authors.initials: Ş
authors.lastname: Cüneyitoğlu
authors.affiliation: Department of Anaesthesiology and Reanimation, Çukurova University Faculty of Medicine, Adana, Turkey.
authors.forename: Mediha
authors.initials: M
authors.lastname: Türktan
authors.affiliation: Department of Anaesthesiology and Reanimation, Çukurova University Faculty of Medicine, Adana, Turkey.
authors.forename: Ebru
authors.initials: E
authors.lastname: Biricik
authors.affiliation: Department of Anaesthesiology and Reanimation, Çukurova University Faculty of Medicine, Adana, Turkey.
authors.forename: Dilek
authors.initials: D
authors.lastname: Özcengiz
keywords: Gynecologic surgery; analgesia; postoperative; regional anaesthesia; ultrasound