Author(s): Chiranji Lal Khedia1, Neha Sharma2, Suresh Chandra Dulara3, Somank Gupta4, Sony Khedia5
BACKGROUND AND OBJECTIVES
The present study was carried out to compare duration of analgesia, haemodynamic changes (Systolic and Diastolic Blood Pressure, Pulse Rate, Respiratory Rate), total incremental doses of epidural fentanyl required to maintain VAS <3 up to 24 hours and complications and adverse effects in between epidural 0.125% bupivacaine with fentanyl 50 μg and 0.2% ropivacaine with fentanyl 50 μg for postoperative epidural analgesia.
The study was conducted in 50 adult (aged 20-65 years) patients of ASA class 1 and 2 patients posted for elective lower abdominal surgeries. Patients were randomly divided into two groups of 25 each. Under strict aseptic precautions, epidural catheter was introduced at L2-L3 space in sitting position and 8 mL of distilled water was injected into catheter to check patency, then patients were placed in supine position and general anaesthesia was given to patient. Patients were reversed and shifted to recovery room and they were injected either 10 mL of 0.2% ropivacaine with fentanyl 50 μg (Group RF) or 10 mL of 0.125% bupivacaine along with fentanyl 50 μg (Group BF). Haemodynamic changes were monitored and noted every 5 minutes up to 30 minutes following administration of either drug. Duration of analgesia and any complications and adverse reactions were compared. Incremental doses of inj. fentanyl 50 μg were injected whenever VAS >3 up to 24 hours in each group and total required incremental fentanyl doses were compared between both the groups. Once the data were collected from all the patients, they were compared using, chi-square test, two sample t-test. The p-value was calculated and P <0.05 was considered statistically significant.
The duration of analgesia was more with Group BF (245+17.58 min.) than Group RF (217.6+22.41 min.), thus it is concluded that difference in duration of analgesia was statistically significant between the groups (P<0.05). In this study, it was noticed that patients of Group RF required much more incremental doses of epidural fentanyl (218+31.88 μg) to maintain VAS<3 up to 24 hours than group BF (170+32.27 μg), and difference was statistically significant (P<0.05). Haemodynamic parameters like SBP, DBP, HR and RR were comparable in both the groups. Hypotension and bradycardia were noted in two patients of group BF.
Duration of analgesia was longer and comparatively better in group BF and less incremental doses were required to maintain VAS <3 up to 24 hours as compared to group RF, but haemodynamic stability was more in group RF as compared to group BF.