Comparison between Intravenous Pentazocine and Epidural Analgesia in Postoperative Pain Management of Upper Abdominal Surgeries

Background: Effective postoperative pain management following upper abdominal surgeries remains a significant challenge in perioperative care. This study compared the efficacy and safety of intermittent intravenous Pentazocine with epidural analgesia for postoperative pain management in patients undergoing upper abdominal surgeries. Methods: In this prospective, randomized study, 60 patients (ASA I-II) undergoing elective upper abdominal surgeries were randomly allocated into two groups: Pentazocine Group (Group P, n=30) receiving intermittent intravenous Pentazocine, and Epidural Group (Group E, n=30) receiving epidural analgesia. Primary outcomes included pain scores using Visual Analog Scale (VAS), total analgesic consumption, and time to first analgesic requirement. Secondary outcomes included hemodynamic parameters, side effects, time to mobilization, and length of hospital stay. Results: Group E demonstrated significantly lower VAS pain scores throughout the 48-hour observation period compared to Group P (2.1 ± 0.7 vs 4.2 ± 1.0 at 24 hours, p<0.001). Total analgesic consumption was significantly lower in Group E (82.6 ± 18.4 mg vs 158.4 ± 22.7 mg pentazocine equivalents, p<0.001), with longer time to first analgesic requirement (186.4 ± 24.5 vs 42.3 ± 8.6 minutes, p<0.001). Group E achieved earlier mobilization (18.6 ± 4.8 vs 28.4 ± 6.2 hours, p<0.001) and shorter hospital stay (6.4 ± 1.3 vs 7.8 ± 1.6 days, p<0.001). While Group P showed higher incidence of nausea and sedation, Group E experienced more cases of hypotension, though all complications were successfully managed. Conclusion: Epidural analgesia provides superior pain control, reduced analgesic requirements, earlier mobilization, and shorter hospital stay compared to intermittent intravenous Pentazocine in upper abdominal surgeries. Both techniques demonstrated acceptable safety profiles with manageable side effects.