{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T09:23:44Z","timestamp":1762161824620,"version":"3.32.0"},"reference-count":38,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T00:00:00Z","timestamp":1711065600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Enhanced recovery after surgery (ERAS) protocols have been introduced in gynecology. Postoperative pain management after vaginal procedures remains a relevant issue. In the present study we aimed to evaluate the effectiveness of pre\u2010emptive uterosacral\/cervical block (PUCB) for postoperative pain control in patients with uterovaginal prolapse undergoing vaginal hysterectomy and pelvic floor repair. We also evaluated the impact on the length of recovery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a pilot study analyzing 40 women who underwent pelvic organ prolapse repair through uterosacral ligament suspension. Patients who chose to undergo PUCB were considered as cases, otherwise as controls. After general or spinal anesthesia induction, the treatment group received the PUCB with ropivacaine plus clonidine injections at 2, 4, 8, and 10 o'clock of the cervix. The control group did not receive additional treatment. Pain intensity was measured at rest and after forceful cough at 1, 4, 8, 12, 24, and 48\u2009h postoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found a significant reduction in pain values at 1\u2009h (rest and forceful cough) and 24\u2009h (forceful cough) in the PUCB group. The incidence of moderate\/severe pain was inferior in the PUCB group at 1\u2009h (rest) and 24\u2009h (rest and forceful cough). There were no differences in terms of the use of rescue opioids (0% vs. 5%; <jats:italic>P<\/jats:italic>\u2009=\u20090.311) and length of hospital stay (2.5\u2009\u00b1\u20090.6 vs. 2.3\u2009\u00b1\u20090.6; <jats:italic>P<\/jats:italic>\u2009=\u20090.180).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>For the first time, we demonstrated the impact of pre\u2010emptive uterosacral\/cervical block on pain control up to 24\u2009h after surgery. Clonidine as a sensory blockade extender appears promising in enhancing the efficacy of local anesthetics.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.15483","type":"journal-article","created":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T09:24:57Z","timestamp":1711099497000},"page":"1240-1246","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Enhanced recovery after surgery (<scp>ERAS<\/scp>) in prolapse repair: A prospective study on pre\u2010emptive uterosacral\/cervical block"],"prefix":"10.1002","volume":"166","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7495-7185","authenticated-orcid":false,"given":"Marta","family":"Barba","sequence":"first","affiliation":[{"name":"Fondazione IRCCS San Gerardo dei Tintori  Monza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Cola","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS San Gerardo dei Tintori  Monza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Desir\u00e8e","family":"De\u00a0Vicari","sequence":"additional","affiliation":[{"name":"University of Milano\u2010Bicocca  Monza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomaso","family":"Melocchi","sequence":"additional","affiliation":[{"name":"University of Milano\u2010Bicocca  Monza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauro\u00a0Angelo","family":"Gili","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS San Gerardo dei Tintori  Monza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Frigerio","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS San Gerardo dei Tintori  Monza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,3,22]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.07.039"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002112"},{"key":"e_1_2_11_4_1","doi-asserted-by":"crossref","unstructured":"AartsJW NieboerTE JohnsonN et\u00a0al.Surgical approach to hysterectomy for benign gynaecological disease. 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