Comparison of epidural bupivacaine-fentanyl and ropivacaine-fentanyl for postoperative analgesia in major abdominal surgeries - a prospective, randomised study

Introduction and Aims: The pain after major abdominal surgeries, if treated inadequately, may lead to increased postoperative morbidity and delayed recovery. The present study aims to compare continuous epidural infusion of ropivacaine-fentanyl with bupivacaine-fentanyl for postoperative analgesia in major abdominal surgeries. Materials and Method: This prospective, randomised, double blind study was conducted in 112 patients undergoing major abdominal surgeries. The patients were divided into two groups: each involving 56 patients. One group received 0.125% bupivacaine + 1µg/ml of fentanyl and the other received 0.2 % ropivacaine + 1 µg/ml of fentanyl. Both the infusions were started at a constant rate of 5 ml/h at the end of surgery. The Visual analogue scale (VAS) to assess pain, heart rate, systolic blood pressure, diastolic blood pressure, duration of surgery and anaesthesia, amount of crystalloids used and side effects were noted and compared at different time intervals. The data was analysed using SPSS 20.0 (trial version). Results: The mean of VAS pain score after 1,2,4,6,8,12 and 24 hours of surgery was less in RF group as compared to BF group and the total rescue analgesia consumption in 24 hours after surgery was 2.4 g (mean) in BF group and 1.3 g(mean) in RF group and the difference was statistically significant (P < 0.0001). There were no statistically significant differences in haemodynamic or physiologic variables when compared with both the groups. Conclusion: Analgesic potency and motor sparing effect of ropivacaine-fentanyl is better than bupivacaine-fentanyl at doses used in our study.