Melekamayhu, Abateneh (B.Sc. M.Sc.)Kenna, Peniel2018-11-282023-11-052018-11-282023-11-052018-06http://etd.aau.edu.et/handle/123456789/14618Background: Midline laparotomy incision and other abdominal surgeries are associated with severe postoperative pain. Most experimental studies have showed significant reduction in pain intensity and total analgesia consumption in patients for whom bilateral rectus sheath block was done when compared to none interventional groups. Objectives: To assess the role of bilateral rectus sheath block as part of post-operative analgesia in patients that undergo midline laparotomy at Menelik II Referral Hospital. Methods: A prospective cohort study was done from December 25, 2017 to May 10, 2018 at Menelik II Referral hospital on sixty patients who came for midline abdominal laparotomy by using systematic random sampling technique. For analysis and interpretation, collected data were entered into Epi-data 3.1 and transported to the SPSS version 20. Homogeneity of categorical independent variables between the two groups were analyzed using Chi Square. The Manny Whitney test was used to compare median pain score and total analgesia consumption between the rectus sheath block group and control group. Statistical significance was stated at p value < 0.05 with a power of 80%. Result: There were a statistical significant difference among the groups depending on postoperative pain score measured by numeric rating scale (NRS) in the first 6 hours and total analgesia consumption within the 12 hours post-operatively. The median (inter quartile range) numeric rating scale score at the post anesthesia care unit was 0 (0-3) for treatment and 6 (2-8) for control group with p value of <0.001. Also, the 1st ,2nd ,4th and 6th postoperative hour numeric rating scale score was lower in statistically significant way between the two groups. The median 12-hour postoperative tramadol consumption was 0 mg and 75mg with p value of 0.022 for the rectus sheath group and control group, respectively. Conclusion and Recommendation: For surgeries done through midline laparotomy, adding bilateral rectus sheath block (BRSB) at the end of the operation with 0.25% bupivacaine is useful postoperative analgesia. Based on these, we recommend the use of BRSB for patients that undergo midline abdominal incision.en-USRectus sheath block, midline laparotomy, post-operative pain, numeric rating scaleThesis