RESUMO
To compare the, post op analgesia, vomiting, shivering, length of hospital stay, peri-operative haemodynamic changes and recovery time in patient under going open cholecystectomy under general anaesthesia versus those receiving epidural anaesthesia. Quasi experimental study. Combined Military Hospital Rawalpindi from 15 October 2007 to 15 April 2008. American Society of Anaesthesiology [ASA] physical status [PS] I and ll patient of either gender undergoing un-complicated open cholecystectomy were randomly divided into two groups, group A [n=30] received general anaesthesia [GA] and group B [n=29] received thoracic epidural anaesthesia [EA], Patients of both the groups were assessed for peri-operative haemodynamic changes, recovery time, post op analgesia, vomiting and length of hospital stay. Chi-square test was applied to compare the two groups and obtain P-value. P-value of less than 0.05 was considered significant. 9 out of 30 patients [30%] of group "A" [general anaesthesia] and 4 out of 29 patients [13.79%] in group "B" [epidural anaesthesia] had vomiting. Shivering was seen in 3 out of 30 [10%] in group "A" [general anaesthesia] and 1 out of 29 [3.44%] patient in group "B" [epidural anaesthesia]. Urinary retention was seen in 1 out of 30 [3.33%] in group "A" [general anaesthesia] and B out of 29 [27.5%] in group "B" [epidural anaesthesia]. Urinary retention was relieved by psychotherapy. None of the patient required catheterization. Post operative recovery from surgery was determined by gastrointestinal motility [passage of flatus and start of oral sips]. ln group "A" [general anaesthesia] 6 patients [20%] started oral sips in first post operative day, 16 patients [53.33%] on second post operative day, 8 patients [26.66%] in third post operative day. ln the group "B" [epidural anaesthesia] 13 patients [44.8%] started oral sips on first post operative day, 15 [51.72%] on second post operative day and one patient [3.44%] on third post operative day. Regarding the length of hospital stay 17 patient [56.66%] of group "A" [general anaesthesia] were discharge by third post operative day and 22 patient [75.77] were discharge by third post operative day in group "B" [epidural anaesthesia]. The use of intra-operative epidural anaesthesia combined with postoperative epidural analgesia was found to be associated with reduction in the post operative pain and vomiting in patients undergoing open cholecystectomy.