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Original Article

Author(s): Hossain MM, Mohal N

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 the Department of Anesthesia, Islami Bank Medical College Hospital, Rajshahi, between January 2024 and June 2025 received epidural analgesia via continuous infusion or patient-controlled delivery; pain, recovery, and safety outcomes were recorded serially.

Results: Mean age was 41.0 ± 13.0 years; 54 patients (50.9%) were male. Visual analog scale pain scores declined progressively from 3.72 ± 1.09 at 6 hours to 0.95 ± 0.88 at 72 hours postoperatively (Friedman χ² = 252.6, p < 0.001). Rescue analgesia was required in 30 patients (28.3%), with no significant difference between continuous infusion and patient-controlled epidural regimens (p = 0.78). Mean time to ambulation was 27.97 ± 4.28 hours and mean time to first flatus was 35.71 ± 5.37 hours. Mean hospital stay was 6.37 ± 1.65 days. A total of 102 patients (96.2%) reported satisfaction rated “satisfied” or “very satisfied.” Complications occurred in 4 patients (3.77%), consistent with the prespecified 2–4% benchmark, comprising hypotension, transient motor blockade, catheter-site erythema, and post-dural puncture headache, one case each.

Conclusions: Epidural analgesia produced a consistent, statistically significant decline in postoperative pain scores across 72 hours with a low complication burden in this cohort, 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