Comparison of Epidural and Spinal Anaesthesia for Total Abdominal Hysterectomy

Abstract

Objectives: To compare the time of onset, adequacy of surgical analgesia and motor blockade
with epidural anaesthesia versus spinal anaesthesia for hysterectomy. To compare the frequency
of hypotension and need for switching to general anaesthesia with spinal versus epidural
anaesthesia for hysterectomy.
Material and Methods: One hundred patients with ASA I or II undergoing hysterectomy were
included in the study. Fifty patients underwent surgical procedure under epidural (E) and fifty
under spinal (S) anaesthesia. Both groups were monitored for onset and quality of surgical
analgesia, degree of motor blockade, frequency of hypotension and need for conversion to
general anaesthesia.
Results: The time of onset of surgical analgesia was significantly shorter in spinal group
compared with epidural group (9.12+1.56 vs 21.7+3.59 minutes, p<0.001). The quality of surgical
analgesia was not significantly different in both groups. The degree of motor blockage was
significantly more pronounced in the spinal group (mean modified Broomage scores 1.08 vs 2.10
p<0.01). The frequency of hypotension was more in the spinal group (8 vs 2 patients p<0.05). The
need to convert to general anaesthesia was more common in spinal compared to epidural group
(8 vs 1 patient p<0.05).
Conclusion: Spinal anaesthesia for hysterectomy is associated with quicker onset of action,
better motor blockade. However, both techniques allow adequate level of surgical analgesia
which is not significantly different with spinal or epidural anaesthesia. Frequency of hypotension
and need for conversion to general anaesthesia is more common with spinal compared with
epidural anaesthesia for hysterectomy