The Iranian Journal of Obstetrics, Gynecology and Infertility

The Iranian Journal of Obstetrics, Gynecology and Infertility

Pain Control after Hysterectomy Surgery: A Systematic Review

Document Type : Review Article

Authors
Mansour Deylami 1
Kaveh Hedayati Emami 2
Samira Katebi 3
Masoud Ghanei 4
Majid Vatankhah 5
Mehrdad Malek-Shoar 5
Pouria Adibi 6
Tayyebeh Zarei 6
Somayeh Mehrpour 7
1 Assistant Professor, Department of Anesthesiology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.Golestan University of Medical Sciences
2 Assistant Professor, Department of Anesthesiology and Critical Care, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
3 M.Sc. in Midwifery, School of Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
4 Assistant Professor, Department of Anesthesiology, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
5 Associate Professor, Department of Anesthesiology, Anesthesiology, Critical Care and Pain Management Research Center, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
6 Assistant Professor, Department of Anesthesiology, Anesthesiology, Critical Care and Pain Management Research Center, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
7 Anesthesiologist, Rajaie Cardiovascular Research Center, Rajaie Cardiovascular Medical and Research Institute, Tehran, Iran.
10.22038/ijogi.2025.75797.5898
Abstract
Introduction: Trying to control postoperative pain in patients undergoing hysterectomy surgery in order to improve faster and reduce the length of hospitalization has always been the focus of gynecological surgeons. The present study was conducted as a systematic review with aim to evaluate postoperative pain control following hysterectomy.
Methods: In this systematic review study, all the articles that were the result of clinical trials conducted in Iran in Persian or English, without time limit until 30 September 2022 (September 21, 2023), were reviewed by searching in Scopus, PubMed, Magiran, SID, Medlib, Cochrane, Science Direct and Google Scholar search engine. To search for articles in Persian sources, the keywords hysterectomy, abdominal hysterectomy, pain, spinal anesthesia, general anesthesia was used and in English sources, their English equivalent, with all their possible combinations were used. Jadad checklist was used to evaluate the quality of the articles. The information obtained include name of the author (first author), year of publication, place of study, investigated drugs, clinical trial code, sample size, age of patients, pain criteria, times of measuring pain intensity and the final outcome of the study were evaluated and reviewed.
Results: Among the reviewed articles, 32 studies were selected. A total of 2688 patients (15–58 years old) were included in the studies. Preoperative administered medications were prescribed 30 minutes to 2 hours before anesthesia and rest were administrated during or after surgery. The most investigated drugs in the studies were related to gabapentin and ketamine with 7 studies and the least related to drugs; clonidine, dexamethasone, magnesium oxide, diclofenac, tramadol, morphine, dexmedetomidine, tizanidine and naproxen with 1 study.
Conclusion: Gabapentin drug can reduce pain after hysterectomy surgery. It seems that this drug can be used as a suitable alternative to opioids in hysterectomy surgery.
Keywords
Hysterectomy
Pain Control
Postoperative Pain
Subjects
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The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 29, Issue 1
March 2026
Pages 81-101