A Pilot Randomized Controlled Trial Comparing Presacral Nerve Block to Sham Block in Total Laparoscopic Hysterectomy
Bibliographic record
Abstract
Objective: This study sought to determine if a presacral nerve (PSN) block affects early postoperative pain, opioid use, and rates of urinary retention after laparoscopic hysterectomy. Materials and Methods: Patients who had elective total laparoscopic hysterectomy (TLH) without histories of chronic pain or opioid use were assigned randomly to either a PSN block of 10 mL of 0.5% bupivacaine or a sham block of 10 mL normal saline post surgery. The primary outcome was pain assessed on a visual analogue scale (VAS) at 3 hours postoperatively and secondary outcomes included pain at 1, 2, and 3 hours, and opioid use post surgery. Participant recruitment was halted due to cancellation of elective surgeries during the COVID-19 pandemic, and, therefore, the data of the patients who were already recruited, was analyzed as an interim analysis for a pilot study design. Results: Thirty-four patients were recruited, with 21 in the intervention group and 13 in the sham-block group. Operative times were similar between both groups. Postoperative pain (measured at 1, 2, and 3 hours post surgery) was not significantly different between the 2 groups. Fewer patients in the PSN group required fentanyl for pain control in the recovery room (28.6% versus 53.8%; p = 0.041), although there was no statistically significant difference in terms of overall opioid consumption. There were no complications related to PSN-block administration. Conclusions: PSN block appears to be feasible and may contribute to decreased opioid use following laparoscopic hysterectomy. As participant recruitment was halted, a robust, well-powered, randomized control trial is necessary. (J GYNECOL SURG 20XX:000)
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".