Comparison of Spinal and Epidural Anaesthesia for Hysterectomy Post Operative Pain and Complications

Open Access

Abstract

Background: The choice of an aesthetic technique significantly influences postoperative pain control and recovery following hysterectomy. Spinal and epidural anesthesia are widely used regional techniques, yet comparative evidence regarding their postoperative analgesic efficacy and complications remains inconsistent. Objective: To compare spinal and epidural anesthesia in terms of postoperative pain, analgesic requirement, and complications in patients undergoing hysterectomy. Methods & Materials: This prospective comparative study was conducted at Uttara Adhunik Medical College and Hospital, Dhaka, Bangladesh, from July to December 2024. Forty adult female patients scheduled for elective hysterectomy were allocated into two groups: spinal anesthesia (Group S, n = 20) and epidural anesthesia (Group E, n = 20). Postoperative pain was assessed using the Visual Analog Scale (VAS) at 2, 6, 12, and 24 hours. Time to first rescue analgesia, total analgesic consumption within 24 hours, and postoperative complications were recorded and analyzed. Results: Baseline demographic and perioperative variables were comparable between groups. VAS pain scores were significantly lower in the epidural group at 6, 12, and 24 hours postoperatively (p < 0.001). Time to first rescue analgesia was significantly longer in the epidural group (7.8 ± 1.5 hours) compared to the spinal group (3.4 ± 1.1 hours; p < 0.001). Total analgesic consumption within 24 hours was lower in the epidural group (1.6 ± 0.7 vs. 3.2 ± 0.9 doses; p < 0.001). Post-dural puncture headache and hypotension occurred more frequently in the spinal group, while no serious adverse events were observed. Conclusion: Epidural anesthesia provides superior and sustained postoperative analgesia with reduced analgesic requirements compared to spinal anesthesia in hysterectomy patients.