Impact of Spinal versus Epidural Anesthesia on Perioperative Hemodynamics in Lower Abdominal Surgery

Abstract

Background: Regional anesthesia, including spinal and epidural ‘ techniques, is widely used in lower abdominal surgeries, with each method exhibiting distinct hemodynamic profiles that influence perioperative cardiovascular stability. Aim: To compare the intraoperative hemodynamic effects of spinal versus epidural anesthesia in patients undergoing elective lower abdominal surgeries. Methodology: This prospective, randomized, observational study included 80 patients aged 18–70 years, classified as ASA I–II, and scheduled for elective lower abdominal procedures. Participants were equally allocated to receive either spinal anesthesia (Group S) or epidural anesthesia (Group E). Hemodynamic parameters— systolic and diastolic blood pressure, mean arterial pressure, and heart rate—were monitored at baseline and at 5- minute intervals for the first 30 minutes post-block. Vasopressor requirements and postoperative complications were also recorded. Results: Both groups were comparable at baseline. Group S exhibited a greater initial drop in blood pressure but required fewer vasopressors (20% vs. 10%). Heart rate variations were minimal in both groups. Post-dural puncture headache occurred only in the spinal group (7.5%). Epidural anesthesia demonstrated relatively stable blood pressure but slightly higher hypotension incidence with high-volume dosing. Conclusion: Spinal anesthesia provides rapid, predictable blockade with favorable intraoperative hemodynamic stability, whereas epidural anesthesia offers titratable dosing and prolonged analgesia at the cost of minor hypotension risk.