A comparative study of epidural ropivacaine and epidural ropivacaine with fentanyl for perioperative analgesia in patients undergoing elective gynaecologial surgery
Journal Title: Medpulse International Journal of Anesthesiology - Year 2018, Vol 5, Issue 2
Abstract
Background: Different drugs have been tried as adjuvants to local anaesthestic agents administered epidurally to prolong postoperative analgesia. This randomised prospective study was designed to assess and compare the efficacy of fentanyl used as adjuvant to ropivacaine for epidural analgesia in patients undergoing elective gynaecological surgery. Methods: Eighty female patients of ASA Grade I and II, within age group of 20 to 60 years undergoing elective gynaecological surgery were included in one of the two following groups. Patients with pre-existing neurological, cardiac, spinal deformity, local infection in the lumber region and known hypersensitivity to amide local anaesthetics were excluded from the study. Group A patients received 15 – 20 ml of 0.75% ropivacaine hydrochloride epidurally and Group B patients received 15- 20 ml of 0.75% ropivacaine hydrochloride plus 50 mcg of fentanyl citrate. Results: Group B patients had early onset of sensory and motor block and longer duration of analgesia compared to Group A. There was no significant difference in heart rate, mean arterial pressure, distribution of block height and duration of sensory and motor block in both groups. Conclusion: Addition of fentanyl citrate to ropivacaine hydrochloride in epidural anaesthesia, significantly hasten the onset of both sensory and motor block; though, height of the sensory block, duration of sensory (two segment regression) and motor (full motor power and joint movement) block do not alter much. However it causes significant prolongation in duration of analgesia without significant cardiovascular instability and side effects.
Authors and Affiliations
Atasi Das, Amit Kumar Bandyopadhyay, Sudipta Kumar Mandal, Juthika Biswas
Keywords
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