<![CDATA[Background: Hysterectomy is among the most frequently performed major surgical procedures. General anesthesia (GA) remains the most commonly used technique. The selection between GA and spinal anesthesia (SA) can significantly impact patient outcomes, particularly in terms of pain control and the incidence of postoperative nausea and vomiting. This systematic review and meta-analysis aim to compare the effects of GA versus SA on duration of operation, pain intensity, post-operative analgesic consumption, and the incidence of nausea and vomiting in patients undergoing hysterectomy. Methods: This systematic review and meta-analysis were conducted to assess the duration of operation, pain intensity, postoperative analgesic consumption, and the incidence of nausea and vomiting in GA and SA in hysterectomy. The data was tested using random-effect models. Result: Out of eight studies, a total of 1.054 patients were included. Our findings indicate that the intensity of postoperative pain in the GA group obtained a significantly higher Visual Analogue Scale (VAS) Score compared to the SA group (MD, 0.84; 95% CI, [0.11, 1.56]; p = 0.02, I² = 56%). However, no significant results were found on other outcomes including operative time (MD, 1.95; 95% CI, [-1.30, 5.19]; p = 0.24, I² = 10%), analgesic consumption (MD, -7.48; 95% CI, [-20.38, 5.43]; p = 0.26, I² = 96%) and nausea vomiting events (RR, 0.71; 95% CI, [0.48, 1.05]; p = 0.09, I² = 0%). Conclusion: SA showed significant reductions in pain scores compared with GA, suggesting potential benefits for pain relief. However, the choice of anesthesia should be guided by patient-specific factors, the complexity of the surgery, and clinical preferences.]]>
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