Comparing the Effect of General Anesthesia and Spinal Anesthesia on Postoperative Pain after Abdominal Hysterectomy: A Randomized Clinical Trial

Abstract

Background and purpose: Postoperative pain is a common problem after hysterectomy. The purpose of this study was to compare the effect of general anesthesia and spinal anesthesia on pain intensity and hemodynamic changes after abdominal hysterectomy. Materials and methods: This clinical trial was performed in 100 women, ASA class I and II, 35 to 70 years of age, and candidate for abdominal hysterectomy. Patients were randomly divided into two groups: spinal anesthesia with bupivacaine and general anesthesia with isoflurane. The pain was assessed based on the visual analogue scale (VAS) at rest, after coughing at the time of recovery admission, and at 6, 24 and 48 hours after surgery. Postoperative hemodynamic changes were assessed in recovery every 5 minutes for half an hour. Data analysis was done applying T-test, Mann-Whitney, and Chi-Square tests. P-value less than 0.05 was considered significant. Results: The mean scores for pain in rest and coughing at the time of recovery admission in the spinal anesthesia group were 0.10±0.46 and 0.40 ± 1.12, and in the general anesthesia group were 3.44±1.40 and 5.88±1.79, respectively (P<0.001). Changes in systolic and diastolic blood pressure in the spinal anesthesia group were significantly lower than those in the general anesthesia group (P<0.001). Conclusion: Pain score in spinal anesthesia was lower than that in general anesthesia in patients undergoing abdominal hysterectomy. Spinal anesthesia is believed to be better than general anesthesia for abdominal hysterectomy.

Keywords

• abdominal hysterectomy
• spinal anesthesia
• general anesthesia
• analgesia