Résumé
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+2.56 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