A comparison of the analgesic efficacy and safety of epidural bupivacaine with fentanyl and ropivacaine with fentanyl in abdominal surgery

Abstract EN

Context Epidural bupivacaine remains the most widely used local anesthetic for postoperative pain relief, but ropivacaine is increasingly being used as it has less cardiac toxicity.

Aim To compare the analgesic effi cacy and safety of epidural bupivacaine with fentanyl versus ropivacaine with fentanyl during abdominal surgery and in the immediate postoperative period.

Materials and methods One hundred patients undergoing abdominal surgeries under general anesthesia with supplementary epidural analgesia were studied.

Group B received an epidural infusion of 0.2% bupivacaine with fentanyl 2 mcg/ml at 6 ml/h intraoperatively and 0.1% bupivacaine with fentanyl 2 mcg/ml at 6 ml/h postoperatively.

Group R received an epidural infusion of 0.2% ropivacaine with fentanyl 2 mcg/ml at 6 ml/h intraoperatively and 0.1% ropivacaine with fentanyl 2 mcg/ml at 6 ml/h postoperatively.

Results Intraoperative and postoperative heart rate and mean arterial pressure in both groups were comparable.

Pain scores were signifi cantly higher in group B postoperatively up to 24 h.

The number of epidural topups required was comparable intraoperatively, but in the postoperative period, group B needed signifi cantly more number of epidural topups.

The requirement of rescue analgesia showed no signifi cant difference intraoperatively and postoperatively between groups.

Conclusion An epidural infusion of ropivacaine 0.2% with fentanyl provides better intraoperative and postoperative analgesia compared with bupivacaine 0.2% with fentanyl.