Introduction/Background Rectus sheath block (RSB) is increasingly utilised as a part of multimodal analgesia in laparotomy surgeries. We proposed this study to compare the analgesic efficacy of ultrasound-guided bilateral RSB with local anaesthetic (LA) infiltration in patients undergoing midline laparotomy for gynecologic cancer.

Methodology In our prospective, single-centre, three-blinded, randomized clinical trial, we enrolled a total of 60 patients with gynecologic malignancy undergoing surgery through a midline laparotomy at a tertiary referral hospital were randomized to either the LA infiltration (group L, n=30) or ultrasound-guided bilateral RSB (group R, n=30) with 20 ml of 0.25% bupivacaine end operatively. The categorical and ordinal variables were analysed using Chi-square/Fisher’s exact test. The continuous and discrete variables were analysed using Mann-Whitney/independent Student t-test. P-values <0.05 were considered as statistically significant.

Results The mean numeric rating scale pain scores in the postoperative period were significantly lower with RSB when compared with LA. Postoperative numeric rating scale scores at 2nd (P=0.069), 6th (P=0.001), 12th (P<0.001), and 24th (P=0.010) hours were statistically significantly lower in the RSB group. The time to first rescue analgesia was prolonged with RSB (P=0.041).

Conclusion The bilateral rectus sheath block might be an effective analgesic option for midline laparotomy. There was a significant prolonged time to first rescue analgesia with RSB.

Disclosures None