Browsing by Author "Petros Baboker"

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    Effectiveness of Ultrasound-guided Rectus Sheath Block versus Conventional Systemic Analgesia for Pain Control and Quality of Recovery after Midline Laparotomy: A Prospective Cohort Study
    (2025-05-01) Petros Baboker
    ABSTRACT Introduction: Postoperative pain is a significant concern following laparotomy. Previous studies in Ethiopia have reported a high prevalence of moderate-to-severe pain among surgical patients. Despite advances in perioperative care, the effectiveness of the rectus sheath block remains poorly investigated in resource-limited settings. Therefore, studying the effectiveness of ultrasound-guided rectus sheath block over conventional systemic analgesia for pain control and quality of recovery is an important aspect for improving postoperative outcomes. Objective: The main aim of the study was to assess the effectiveness of ultrasound-guided rectus sheath block versus conventional systemic analgesia for pain control and quality of recovery after midline laparotomy from July 1 to September 30 /2025 Method and Materials: An institution-based prospective cohort study was conducted from July 1 to September 30/2025, by recruiting 39 patients in the rectus sheath (RSB) group and 39 patients in the conventional systemic analgesia (CSA) group using a systematic random sampling technique. The exposed group received an ultrasound-guided rectus sheath block with 40ml of 0.25% bupivacaine bilaterally, whereas the non-exposed group received routine postoperative systemic analgesia. Data cleaning and analysis were done on SPSS version 26. The Independent sample t-test and the Mann-Whitney U test were used for normally and non-normally distributed data, respectively. P-values of < 0.05 at 95% CI were considered statistically significant. Result: Patients receiving ultrasound-guided rectus sheath block reported significantly lower mean Numeric Rating Scale scores than those managed with conventional systemic analgesia during the first eight hours postoperatively (p<.05). The mean time to first rescue analgesic was prolonged among the exposed group (579 min vs. 302 min, p<.001). Twenty-four hours analgesic consumption was also significantly reduced among exposed patients (p<.001), and Quality of recovery at 24 hours was higher in the exposed group than in the non-exposed group (111.15±7.07 vs 94.03±7.15; mean difference =17.13; (95% CI: 13.92–20.34; p<.001)). Conclusion: Ultrasound-guided RSB provides superior postoperative pain control, delays the need for rescue analgesia, and enhances recovery quality in midline laparotomy. We recommend practice of Ultrasound-guided RSB as a routine post-operative pain management protocol. Key words: Rectus sheath block, Laparotomy, Pain, Recovery, Cohort