Comparative study between epidural bupivacaine with fentanyl versus ropivacaine with fentanyl combination for post operative analgesia in lower abdominal and lower limb surgeries

Abstract

Background: Adequate analgesia aids to restore normal functions including ventilation, coughing and mobility, thereby facilitating early rehabilitation and shortened hospital stay. Present study was aimed to compare epidural Bupivacaine with fentanyl versus ropivacaine with fentanyl combination for post operative analgesia in lower abdominal and lower limb surgeries at a tertiary hospital. Material and Methods: Present study was comparative, interventional study, conducted in patients aged 18–65 years, either gender, American Society of Anesthesiologists (ASA) physical status I–II, posted for elective lower abdominal and lower limb surgeries. This single-blind study comprised a sample size of 30 patients randomly allocated (by computer generates list) into two groups as Group R (0.125% ropivacaine with 1 ug/ml fentanyl) and Group B (0.125% bupivacaine with 1 ug/ml fentanyl). Results: We compared various parameters such as Age (years), Weight (kg), BMI (kg/m2), Gender, ASA status, Type of surgery, Duration of surgery (min), Intraoperative fentanyl (μg), Catheter insertion level (L1-L2/L2-L3), all parameters were comparable and difference was not significant statistically. Common surgeries considered for study were ovarian debulking surgeries, Wertheim’s hysterectomy, orthopaedic lower limb surgeries (THR, TKR) and hemicolectomy. Post-operative analgesia was calculated on basis of VAS scores. We noted in less post-operative VAS scores at 6,12,18 hours in group R and difference was statistically significant. Conclusion: Epidural ropivacaine with fentanyl combination seems to be a better alternative to epidural bupivacaine with fentanyl, as it provides comparable stable hemodynamics, early onset and prolonged post‑op analgesia, lower consumption of post‑op local anaesthetic for epidural analgesia.