Evaluation of efficacy of epidural and wound infiltration analgesia for total abdominal hysterectomy: A comparative study

Abstract

Background: Abdominal hysterectomy is one of the most commonly performed gynaecological operative procedures. While in cases adequate analgesia is provided by epidural infusion with local anaesthetics, literature quotes considerable case reports highlighting the presence of complications associated with it. Hence; the present study was undertaken for comparing and evaluating the efficacy of epidural and wound infiltration analgesia for total abdominal hysterectomy. Materials & methods: A total of 50 patients between the age group of 30 to 55 years and belonging to ASA grade of I/II were enrolled. Complete demographic and clinical profile of all the patients was recorded. All the patients were randomized into two study groups as follows: Group 1: Patients who received epidural analgesia, and Group 2: Patients who received wound infiltration analgesia. Visual analogue scale (VAS) was calculated on a scale of 0 to 10 (0 indicating no pain and 10 indicating worst pain). Apart from assessing VAS, time to first analgesic requirement was also recorded. All the results were recorded in Microsoft excel sheet and were analysed by SPSS software. Results: Mean VAS among patients of group 1 was significantly lower in comparison to patients of group 2 at 8 hours and 12 hours postoperatively. In the present study, mean time to first analgesic requirement among patients of group 1 and group 2 was 8.99 minutes and 9.16 minutes respectively. Non-significant results were obtained while comparing the mean time to first analgesia and mean hospital stay among the two study groups. Conclusion: Continuous epidural analgesia has superior efficacy in comparison to wound infiltration analgesia in patients undergoing abdominal hysterectomy.