Effect of Combined Epidural Anaesthesia Using 0.125% Inj Levobupivacaine Hydrochloride with General Anaesthesia for Hemodynamic Stability Intraoperatively and Post-Operative Analgesia in Emergency Exploratory Laparotomy Patients

Background: The aim of the study was to evaluate the efficacy of combined General Anesthesia - Epidural Anesthesia (CEGA) for hemodynamic stability in the intraoperative period and post-operative analgesia Method: Authors conducted a prospective study, in which 40 patients undergoing exploratory laparotomy received combined GA and Epidural Anesthesia (CEGA). Authors analyzed the effect of combined epidural general anesthesia with regards to hemodynamic parameters (heart rate, systolic and diastolic blood pressure), post-operative analgesic requirement (intraoperative requirement of fentanyl) and postoperative analgesia (VAS score). Results: Authors found significant decrease in the heart rate, systolic and diastolic blood pressure in response to intraoperative surgical stress response in these patients. No rescue analgesia was required in post-operative period. Pain score (VAS- Visual Analogue Scale) score was also evaluated which was remarkable. There were no significant intraoperative and postoperative complications noted in these patients. Conclusion: Authors concluded that the use of epidural along with general anesthesia helps in attenuating hemodynamic changes due to surgical stress response in exploratory laparotomy, which results in maintaining stable intraoperative and postoperative hemodynamics. Combining epidural with general anesthesia results in rapid recovery and also helps in providing good postoperative analgesia.