Combined spinal–epidural anaesthesia and general anaesthesia for total abdominal hysterectomy– A comparative study

Suresh Singhal; Sanjay Johar; Kiranpreet Kaur; Akansha Sangwan

Volume : V, Issue : XI, November - 2015

Combined spinal–epidural anaesthesia and general anaesthesia for total abdominal hysterectomy– A comparative study

Suresh Singhal, Sanjay Johar, Kiranpreet Kaur, Akansha Sangwan

Abstract :

Background: Abdominal hysterectomy can be performed under general or regional anaesthesia, but preferred anaesthetic technique is general anaesthesia. The aim of this study was to compare two anaesthetic techniques, general anaesthesia (GA) and combined spinal epidural anaesthesia (CSEA) in these patients. Methods: It was a prospective and randomized study. Sixty patients of age group 30–60 years, ASA physical status I or II, scheduled to undergo total abdominal hysterectomy were enrolled in the study. They were randomized into two groups of 30 patients each. Group G received GA and group C received CSEA. The haemodynamic changes, surgeon’s satisfaction, complications, patients satisfaction, severity of postoperative pain based on visual analogue scale and analgesic used were recorded. Results: Intraoperative hemodynamic changes was significantly lower in group C as compared to group G (p<0.05). Surgeon’s satisfaction, patient’s satisfaction and quality of pain relief in two groups were comparable. Blood loss was significantly more in group G as compared to group (p<0.05). Time to first rescue analgesia was significantly more in group C. Total dose of bupivacaine through epidural in 24 hour postoperatively was also significantly more in group G (p<0.05). Conclusions: Our study showed that both CSEA and GA provide comparable surgeon’s satisfaction and patient’s satisfaction. However, CSEA provide better hemodynamics with less postoperative analgesic requirement and less blood loss. So, CSEA is better alternative to GA in TAH patients.