A Study of Post-Operative Outcome with Thoracic Epidural Analgesia in Major Abdominal Surgery

Background: Ideal recovery and complication avoidance in extensive abdominal surgery need good perioperative analgesia.Thoracic epidural anaesthesia (TEA) added to general anaesthesia (GA) is proposed to optimize postoperative outcome.The aim of this study was to assess the post-operative outcome with thoracic epidural analgesia in major abdominal surgery.Methods & materials: This prospective observational study was conducted in Department of Anaesthesia, Analgesia and Intensive Care Medicine, Bangladesh Medical University (BMU), Shahbag, Dhaka, Bangladesh from August 2024 to July 2025.Total 50 patients undergoing major abdominal surgery were included in this study.The patients were divided into two groups: Group A (n=25) received combined epidural with GA, and Group B (n=25) received GA alone.Results: Demographic and preoperative clinical variables were comparable in groups but preoperative SpO was significantly higher in Group B (p<0.0001).In intraoperative intervals, diastolic blood pressure was significantly higher in Group B (p=0.025), whereas pulse, systolic pressure, and SpO were equal.Urine output and random blood sugar did not differ significantly.Hypotension was observed more frequently in the group A, while hypertension was more pronounced in the group B. Post operatively, Group B showed much higher diastolic BP and SpO.VAS score was significantly lower in Group A (p<0.0001) and no rescue analgesic required compared to 96% in Group B. Conclusion: TEA with GA significantly improves postoperative analgesia and reduces the need for analgesics in major abdominal surgery, at the price of a higher risk of hypotension, which makes close haemodynamic monitoring of paramount importance.