DOI: https://doi.org/10.36347/sjams.2026.v14i08.002

Pages: 1093-1098

Background: Effective postoperative pain management following cesarean section is essential for promoting early maternal recovery, facilitating breastfeeding, improving patient satisfaction and reducing postoperative complications. Epidural and spinal anesthesia are widely used regional anesthetic techniques, but their effectiveness in postoperative pain control remains an important area of comparison. Methods: This prospective comparative observational study was conducted in the Department of Anaesthesiology at MH Samorita Hospital and Medical College, Dhaka, Bangladesh, from January 2024 to December 2024 included 70 women undergoing cesarean section, who were equally allocated to either the epidural (n=35) or spinal (n=35) anesthesia group. Postoperative pain was assessed using the Visual Analog Scale (VAS) at 2, 6, 12 and 24 hours after surgery. Data were analyzed using SPSS version 25.0, with p<0.05 considered statistically significant. Results: Baseline demographic and obstetric characteristics were comparable between the groups. The epidural group demonstrated significantly lower VAS pain scores than the spinal group at 2 hours (2.8±1.1 vs. 3.6±1.2), 6 hours (3.4±1.3 vs. 4.8±1.4), 12 hours (3.7±1.2 vs. 5.1±1.5) and 24 hours (2.9±1.0 vs. 3.8±1.2) (all p≤0.004). Time to first rescue analgesic was longer (7.8±2.1 vs. 4.9±1.7 hours), total analgesic consumption was lower (118.6±29.5 vs. 163.7±35.4 mg) and patient satisfaction was higher (8.8±0.9 vs. 7.3±1.2) in the epidural group (all p<0.001). Post-dural puncture headache occurred more frequently after spinal anesthesia (p=0.049). Conclusion: Epidural anesthesia provided superior postoperative pain control, reduced analgesic requirements, higher patient satisfaction and fewer complications than spinal anesthesia following cesarean section.