Comparison on the effects of epidural levobupivacaine and morphine for post operative analgesia following total abdominal hysterectomy

Total abdominal hysterectomy is associated with significant postoperative pain which may delay recovery and mobilization if not adequately managed. Epidural analgesia is an effective technique for postoperative pain relief in major abdominal surgeries.

This prospective randomized double blind parallel group study aims to compare the efficacy and safety of epidural levobupivacaine and epidural morphine for postoperative analgesia in patients undergoing elective total abdominal hysterectomy. Sixty ASA physical status I and II female patients aged 18 to 65 years will be randomly allocated into two groups. Group L will receive epidural levobupivacaine 0.25 percent 10 mL and Group M will receive preservative free epidural morphine 3 mg diluted to 10 mL with normal saline administered via epidural catheter at the end of surgery.

The primary outcome will be the duration of effective postoperative analgesia defined as time to first request for rescue analgesia. Secondary outcomes include postoperative pain scores using visual analogue scale at predefined time intervals, requirement of rescue analgesia, incidence of adverse effects such as nausea vomiting pruritus respiratory depression hypotension and urinary retention and patient satisfaction scores.

The study aims to determine the optimal epidural analgesic regimen that provides effective pain relief with minimal side effects following total abdominal hysterectomy.