Comparative Study of Epidural Anaesthesia Versus Combined Spinal Epidural Block for Surgical Procedures Involving the Lower Abdomen or Lower Limb.

Abstract

Background: Effective anesthesia techniques are essential for managing pain and facilitating recovery in surgical procedures involving the lower abdomen and lower limbs. Epidural anesthesia and combined spinal-epidural (CSE) block are commonly used methods, each with distinct advantages and limitations. This study compared the efficacy, safety, and patient satisfaction of epidural anesthesia versus CSE block in lower abdomen and lower limb surgeries.

Methods: A trial was conducted with 100 participants undergoing elective lower abdomen or lower limb surgeries. Participants were assigned randomly to receive either epidural anesthesia or CSE block. Data on demographic characteristics, intraoperative and postoperative pain scores, analgesic consumption, complications, and duration of hospital stay were collected and analyzed using SPSS version 23.0.

Results: The CSE block group had significantly decreased postoperative pain levels at 1, 6, 12, and 24 hours contrasted to the epidural group (p<0.001). Total post-operative analgesic consumption was decreased in the CSE group (p<0.001). The groups had similar hypotension, nausea, and urine retention rates. Although not statistically significant (p=0.09), the CSE group had a shorter mean hospital stay.

Conclusion: The CSE block provides superior postoperative pain relief and reduces the need for additional analgesics compared to epidural anesthesia, without increasing the risk of complications. These findings suggest that CSE block may be a more effective option for managing postoperative pain in lower abdomen and lower limb surgeries.

Recommendations: Larger trials with long-term follow-up are needed to confirm these findings and examine CSE block's benefits in diverse surgical settings.

Keywords: Epidural anesthesia, Combined spinal-epidural block, Lower abdomen surgery, Lower limb surgery, Postoperative pain management.