Superior hypogastric plexus nerve block in minimally-invasive gynaecology: a double-blind randomised controlled trial

Clinical trial to evaluate the efficacy of a superior hypogastric plexus nerve block with 10ml 0.75% ropivacaine in reducing opiate requirements in the first 24 hours after minimally invasive gynaecological surgery. This was a double-blind RCT at a single institution. Primary outcome was the total opiate use in first 24h after surgery (mag of fentanyl). Secondary outcome was patient pain measured on a visual analogue scale (1 to 10) at 1, 2, 6, 12 and 24-hours post-surgery.. Patients were randomised over a 5-month period, March to July 2020. 27 patients were randomised to receive a nerve block and 23 to the control. There were no significant demographic or intraoperative differences between the two groups. Opiate use followed a non-parametric distribution. A 40% median opiate reduction was seen in patients randomised to the nerve block (p=0.02). Pain scores were significantly lower in the nerve-block group compared with no-block group at 1 hour and 12 hours. Mean pain scores were 2.67 vs 4.00 at 1 hour (p=0.035) and 1.07 vs 2.09 (p=0.033) at 12 hours respectively