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General Anesthesia + Spinal anesthesia (University of Saskatchewan protocol) is a clinical trial intervention designed to optimize postoperative pain management in women undergoing total abdominal hysterectomy. The protocol utilizes a multimodal analgesic approach, combining a spinal anesthetic block (consisting of bupivacaine, fentanyl, and morphine) with a standard general anesthesia induction and maintenance regimen (including midazolam, propofol, rocuronium, and sevoflurane). Preoperative oral analgesics such as acetaminophen and naproxen are also administered. The intervention aims to provide superior pain control and reduce the consumption of systemic opioids (morphine PCA) in the postoperative period by targeting multiple nociceptive pathways through local anesthetic sodium channel blockade, central mu-opioid receptor activation, and GABAergic modulation of the central nervous system.
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