Comparing Spinal and General Anesthesia in terms of Postoperative Pain in Patients undergoing Hysterectomy

Abstract

INTERVENTION: Intervention 1: Intervention group: After anesthetic monitoring including pulse oximetry, ECG and blood pressure monitoring, premedication was administered by injecting benzodiazepine (intravenous midazolam, 2 mg) and a synthetic narcotic (intravenous fentanyl, 1 mg/kg body weight). GA was induced by injecting intravenous thiopental sodium 5 mg/kg bw, and the muscle relaxant, Atracurium, 0.5 mg/kg bw. After endotracheal intubation, inhalation anesthetic(including equal proportions of oxygen and Nitrous oxide, 4 L/min) and evaporation anesthetic (halogenated anesthetic: Isoflurane 1.2%, 1 MAC) were administered to maintainanesthesia and patients underwent mechanical ventilation using anesthesia ventilators.The patient was extubated at the end of the operation after discontinuing anesthetics and reversing the effects of the muscle relaxants using anticholineste rasessuch asneostigmine 40‐70 µg/kg bw and anticholinergicssuch asintramuscular atropine 15µg/kg b w. They were then transferred to PACU (recovery room). Intervention 2: Control group: After anesthetic monitoring of the patient, including pulse oximetry, ECG and blood pressure monitoring, minimal 500 cc crytalloids serum was intravenously administered to prevent hypotension secondary to SA. After placing the patient in a seated position and using povidone‐iodine solution for sterilizing the site of lumbar puncture, the L4/L5intervertebral space was identified. A cutting‐tipped 25‐gauge (orange) spinal needle was inserted into the intrathecal area, and the accuracy of the technique was ensured by the appearance of cerebrospinal fluid. A total of 3 cc hyperbaric bupivacaine solution 0.5%was then injected into the subarachnoid space and the patient was placed in supine position. After stabilizing SA, the position was adjusted so as to allow the local anesthetic to move toward the T8 area. A needle or alcohol‐soaked cotton was used to identify the anesthetic area and the operation began after this area was stabiliz CONDITION: Post Hysterectomy pain. PRIMARY OUTCOME: Post operative pain. Timepoint: After 30 min. Method of measurement: visual analogue scale (VAS). SECONDARY OUTCOME: Nausea. Timepoint: 0, 6 and 12 h after the operation. Method of measurement: Visual Analogue Scale (VAS). Vometing. Timepoint: 0, 6 and 12 h after the operation. Method of measurement: Visual Analogue Scale (VAS). INCLUSION CRITERIA: American Society of Anesthesiologists (ASA) I and II class Candidate for hysterectomy