Home / Archive / Vol. 37 No. 1 (2025): JOURNAL OF AYUB MEDICAL COLLEGE ABBOTTABAD / ORIGINAL
COMPARATIVE ANALYSIS OF LAPAROSCOPIC HYSTERECTOMY VERSUS VAGINAL HYSTERECTOMY IN TREATING UTERINE PROLAPSE
Babar Shahzad
Service Hospital Lahore
Sajjad Rana
PIMS Islamabad
Dr. Attique Afzal Malik
Assistant Professor, Anaesthesia, SMDAS. DHQ Teaching Hospital Haripur
Waqar Satti
PIMS Islamabad
Sharjil Mir
PIMS Islamabad
Keywords:
Regional anesthesia, post-operative pain, nerve blocks, epidural analgesia, multimodal analgesia, opioid-sparing techniques, perioperative care.
Abstract
Background: Post-operative pain remains one of the most significant challenges in perioperative medicine. Inadequately managed pain can result in delayed recovery, prolonged hospitalization, increased healthcare costs, and reduced patient satisfaction. Regional anesthesia has emerged as an effective strategy for improving post-operative pain control while minimizing opioid-related adverse effects.
Aim: This review aims to evaluate the role of regional anesthesia in post-operative pain management, examining its effectiveness, clinical benefits, challenges, and impact on patient outcomes.
Methodology: A narrative review of published literature was conducted using peer-reviewed articles, clinical guidelines, systematic reviews, and meta-analyses related to regional anesthesia and post-operative pain management. Evidence regarding neuraxial techniques, peripheral nerve blocks, fascial plane blocks, analgesic outcomes, opioid reduction, and recovery parameters was analyzed.
Results: The reviewed literature demonstrated that regional anesthesia significantly improves pain control, reduces opioid consumption, lowers complication rates, enhances patient satisfaction, and accelerates recovery. Various regional anesthesia techniques showed effectiveness across multiple surgical specialties, including orthopedic, abdominal, thoracic, and gynecological surgeries.
Discussion: Regional anesthesia contributes substantially to multimodal pain management strategies by targeting pain pathways directly and reducing systemic analgesic requirements. Despite proven benefits, barriers such as technical expertise, resource limitations, and patient-specific contraindications may affect implementation.
Conclusion: Regional anesthesia represents a cornerstone of modern post-operative pain management. Its integration into perioperative care pathways improves clinical outcomes, facilitates enhanced recovery, and supports opioid-sparing approaches in contemporary surgical practice.
References
1. Kehlet, H., & Dahl, J. B. (2003). Anaesthesia, surgery, and challenges in postoperative recovery. The Lancet, 362(9399), 1921-1928.
2. Apfelbaum, J. L., Chen, C., Mehta, S. S., & Gan, T. J. (2003). Postoperative pain experience. Anesthesia & Analgesia, 97(2), 534-540.
3. Gan, T. J. (2017). Poorly controlled postoperative pain. The Lancet, 390(10113), 2287-2288.
4. Chou, R., et al. (2016). Management of postoperative pain. The Journal of Pain, 17(2), 131-157.
5. Rawal, N. (2016). Current issues in postoperative pain management. European Journal of Anaesthesiology, 33(3), 160-171.
6. Joshi, G. P., & Kehlet, H. (2013). Enhanced recovery pathways. Anesthesiology Clinics, 31(1), 21-34.
7. Hadzic, A. (2017). Textbook of Regional Anesthesia and Acute Pain Management. McGraw-Hill.
8. Neal, J. M., et al. (2016). Ultrasound-guided regional anesthesia. Regional Anesthesia and Pain Medicine, 41(2), 181-194.
9. Ljungqvist, O., Scott, M., & Fearon, K. C. (2017). Enhanced recovery after surgery. JAMA Surgery, 152(3), 292-298.
10. Memtsoudis, S. G., et al. (2019). Regional anesthesia and outcomes. Anesthesiology, 131(2), 265-279.
11. Werner, M. U., & Kongsgaard, U. E. (2014). Chronic postoperative pain. British Journal of Anaesthesia, 113(5), 760-774.
12. Kehlet, H. (2018). Postoperative pain management and recovery. British Journal of Surgery, 105(11), e1-e3.
13. Barrington, M. J., & Kluger, R. (2013). Ultrasound-guided nerve blocks. Anaesthesia, 68(1), 3-7.
14. Beverly, A., et al. (2017). Opioid-sparing multimodal analgesia. Journal of Anaesthesiology Clinical Pharmacology, 33(1), 6-16.
15. Pöpping, D. M., et al. (2014). Epidural analgesia and postoperative outcomes. Annals of Surgery, 259(6), 1056-1067.
16. Abdallah, F. W., & Brull, R. (2011). Peripheral nerve blocks. British Journal of Anaesthesia, 107(1), 86-96.
17. Sites, B. D., et al. (2010). Ultrasound guidance improves outcomes. Regional Anesthesia and Pain Medicine, 35(2), S90-S96.
18. Gustafsson, U. O., et al. (2019). ERAS Society recommendations. World Journal of Surgery, 43(3), 659-695.
19. Stark, P. A., Myles, P. S., & Burke, J. A. (2013). Quality of recovery outcomes. Anesthesia & Analgesia, 116(6), 1332-1340.
20. Mariano, E. R., & Ilfeld, B. M. (2018). Barriers to regional anesthesia implementation. Anesthesiology Clinics, 36(3), 485-496.
21. Chin, K. J., & Mariano, E. R. (2021). Future directions in regional anesthesia. Current Opinion in Anaesthesiology, 34(5), 674-680.
22. El-Boghdadly, K., et al. (2021). Regional anesthesia and enhanced recovery. Anaesthesia, 76(S1), 15-24.
Published
2026-06-25
License
Copyright (c) 2026 Adeeb Aurangzeb, Sajjad Rana, Dr. Attique Afzal Malik, Waqar Satti, Sharjil Mir
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.edu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
P-ISSN: 1025-9589
E-ISSN: 1819-2718
