A comparison of ropivacaine with fentanyl to bupivacaine with fentanyl for post-operative patient controlled epidural analgesia in patients undergone lower abdominal cancer surgery

Background: PCEA (patient controlled epidural analgesia) is a safe and effective technique for post-operative analgesia on routine surgical wards. Use of the epidural catheter as part of a combined epidural-general anesthetic technique results in less pain and faster patient recovery immediately after surgery than general anesthesia followed by systemic opioids does. Aim: In this prospective, randomized, double ? blind study, we compared the analgesic effectiveness, hemodynamic changes and other side effects of epidural analgesia with drug combination ? bupivacaine with fentanyl and ropivacaine with fentanyl in different concentrations. Material and methods: It was a prospective, randomized, double ? blind study. Sixty patients of ASA I-II and age group 18-65 years divided in four groups 15 patients in each group (Group B1 bupivacaine 0.1%; Group B2 bupivacaine 0.05%; Group R1 ropivacaine 0.1%; Group R2 ropivacaine 0.05% with fentanyl 5micrograms/ml in each groups). After taking consent from patients epidural catheter was placed and study drugs were given to every patient. Visual analogue scale, heart rate, blood pressure, sedation score, modified bromage scale and other side effects were noted for the next 48 hours. Statistical analysis was done by using Medcalc 12.2.1.0 version statistical analysis software. Results: All four groups were comparable in terms of analgesia but group B1 patients had significant decrease in blood pressure at all time intervals. This group also had loss in motor power of lower extremity p value 0.020 than all other three groups. Conclusions: We concluded that ropivacaine 0.1% with fentanyl 5 ?g/mL after major abdominal surgery provides optimal dynamic analgesia without significant adverse effects.