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After major abdominal surgery and open hysterectomy, postoperative pain management is often challenging. Various abdominal fascial and truncal blocks, including paravertebral, erector spinae plane, transversus abdominis plane, and quadratus lumborum blocks, have been evaluated for their efficacy. When used in a multimodal pain control strategy, after an open abdominal hysterectomy under spinal anesthesia, the novel sacral erector spinae plane block showed promising results in terms of safety, efficacy, and minimal invasiveness., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Marrone et al.)