A prospective, randomized study to compare the efficacy of Tramadol versus Nalbuphine as adjuvants to Ropivacaine in transversus abdominis plane block for post-operative analgesia in patients undergoing elective abdominal hysterectomy under spinal anesthesia.

Elective abdominal hysterectomy often results in significant postoperative pain, making effective analgesia essential for recovery. Regional anesthesia, particularly spinal anesthesia and the transversus abdominis plane (TAP) block, offers advantages such as reduced systemic drug use, fewer side effects, and improved postoperative comfort. TAP block provides analgesia by depositing local anesthetics in the neurofascial plane to block T7–L1 nerves. Ropivacaine is preferred for its safety and selective sensory block. Adjuvants like tramadol and nalbuphine enhance and prolong analgesia with fewer adverse effects. This study compares their effectiveness in postoperative pain control, hemodynamic stability, and sedation in abdominal hysterectomy patients.