Postoperative Analgesic Outcomes with Epidural Analgesia Following Major Abdominal Laparotomy: A Prospective Study

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Original Article

PAH Med Col J. Jul 2026; 3(2): 54-65

Abstract

Background: Uncontrolled postoperative pain after major abdominal laparotomy delays mobilization, impairs bowel recovery, and prolongs hospitalization, sustaining interest in regional analgesic strategies.

Objective: This study evaluated pain trajectory, analgesic supplementation, functional recovery, and complication frequency in patients receiving epidural analgesia after major abdominal laparotomy.

Methods and Materials: A prospective study of 106 adults aged 18–65 years undergoing major abdominal laparotomy at Islami Bank Medical College Hospital, Rajshahi, between January 2024 and June 2025, received epidural analgesia via continuous infusion or patient-controlled delivery.

Results: Mean age was 41.0 ± 13.0 years; 54 patients (50.9%) were male. VAS pain scores declined progressively from 3.72 ± 1.09 at 6 hours to 0.95 ± 0.88 at 72 hours (p<0.001). Rescue analgesia was required in 30 patients (28.3%). Mean time to ambulation was 27.97 ± 4.28 hours and mean hospital stay was 6.37 ± 1.65 days. Complications occurred in 4 patients (3.77%).

Conclusions: Epidural analgesia produced a consistent, statistically significant decline in postoperative pain scores across 72 hours with a low complication burden, supporting its continued role in major laparotomy analgesic protocols.

Keywords

Epidural Analgesia, Laparotomy, Postoperative Pain, Visual Analog Scale, Patient-controlled Analgesia


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How to cite: Hossain MM, Mohal N. Postoperative Analgesic Outcomes with Epidural Analgesia Following Major Abdominal Laparotomy: A Prospective Study. PAH Med Col J. Jul 2026; 3(2): 54-65.

DOI: https://doi.org/10.70945/pahmc.v03i02.04