A PROSPECTIVE OBSERVATIONAL STUDY OF COMBINED SPINAL–EPIDURAL ANAESTHESIA FOR POSTOPERATIVE ANALGESIA IN ORTHOPAEDIC, LOWER ABDOMINAL AND OBSTETRIC & GYNAECOLOGICAL SURGERIES

Abstract

Abstract Background:

Effective postoperative pain management plays a crucial role in early mobilisation, enhanced

recovery, and patient satisfaction. Combined spinal–epidural (CSE) anaesthesia offers the advantage of rapid onset of spinal blockade along with prolonged and controllable postoperative analgesia through the epidural route.

Objectives:

To evaluate the efficacy and safety of combined spinal–epidural anaesthesia for postoperative analgesia in orthopaedic, lower abdominal, and obstetric & gynaecological surgeries.

Methods:

This prospective observational study was conducted on 75 patients undergoing elective surgeries under CSE anaesthesia. Patients were equally divided into three groups: orthopaedic surgeries (n=25), lower abdominal surgeries (n=25), and obstetric & gynaecological surgeries (n=25).

Postoperative pain was assessed using the Visual Analogue Scale (VAS) at predetermined intervals. Secondary outcomes included time to first rescue analgesia, total postoperative analgesic requirement, and incidence of adverse effects.

Results:

Postoperative pain scores remained low across all groups. The time to first rescue analgesia was longest in the orthopaedic group, followed by obstetric & gynaecological surgeries, and least in lower abdominal surgeries. Overall analgesic consumption was minimal. Adverse effects were infrequent and mild, with nausea and vomiting observed in 2.6% and mild hypotension in 4% of patients. No serious complications were reported.

Conclusion:

Combined spinal–epidural anaesthesia provides effective and safe postoperative analgesia across orthopaedic, lower abdominal, and obstetric & gynaecological surgeries with minimal adverse effects and prolonged analgesic duration.