Evaluation of Ropivacaine versus Ropivacaine with Fentanyl for Postoperative Epidural Analgesia in Patients Undergoing Elective Lower Abdominal Oncosurgeries- A Randomised Clinical Study
Introduction: Epidural analgesia has emerged as one of the preferred and convenient modes of intraoperative and postoperative management owing to advantage of not interfering with metabolic functions, better tolerability and decrease in reflex activity, similar analgesic properties, less motor...
| Main Authors: | , , , , , |
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| Formato: | Artigo |
| Idioma: | English |
| Publicado em: |
JCDR Research and Publications Private Limited
2021-06-01
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| Colecção: | Journal of Clinical and Diagnostic Research |
| Assuntos: | |
| Acesso em linha: | https://www.jcdr.net/articles/PDF/14927/48890_CE[Ra1]_F[SK]_PF1(SC_RK)_PFA(SC_KM)_PN(KM).pdf |
| Resumo: | Introduction: Epidural analgesia has emerged as one of
the preferred and convenient modes of intraoperative and
postoperative management owing to advantage of not
interfering with metabolic functions, better tolerability and
decrease in reflex activity, similar analgesic properties, less
motor blockade and decreased propensity of cardiotoxicity.
Neuraxial opioids like fentanyl used in epidural analgesia offer
advantage of augmenting local anaesthetic effect and reducing
the anaesthetic and analgesic requirement.
Aim: To compare the adequacy of analgesia, requirement
of rescue analgesics between 0.2% ropivacaine and 0.2%
ropivacaine with 2 mcg/cc fentanyl.
Materials and Methods: The randomised clinical study was
carried out from September 2016 to May 2018 in 70 patients (35
in each group) of American Society of Anaesthesiologists (ASA)
1 and 2 scheduled for elective lower abdominal oncological
surgeries. The anaesthetic intervention in group R was 0.2 %
ropivacaine and group RF was 0.2% ropivacaine with 2 mcg/cc
fentanyl. All data was statistically analyzed and compared using
Student t-test, Chi-square/Fisher-Exact test. The p-value <0.05
was considered to be significant.
Results: Both the groups were compatible with regard to
demographic data and haemodynamic variables. The mean
Visual Analogue Scale (VAS) were higher in group R compared
to group RF at 0, 2, 4, 12, 18 and 24 hours but the observed
difference in both the groups was not statistically significant
except at 1 and 6 hours. Number of rescue analgesics as epidural
boluses (p-value=0.007) and paracetamol (p-value=0.022)
requirement were more in group R compared to group RF
respectively.
Conclusion: On account of adequate postoperative analgesia,
haemodynamic stability, ropivacaine with fentanyl is a better
option than ropivacaine alone for epidural infusion. |
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| ISSN: | 2249-782X 0973-709X |