Evaluation of Ropivacaine versus Ropivacaine with Fentanyl for Postoperative Epidural Analgesia in Patients Undergoing Elective Lower Abdominal Oncosurgeries- A Randomised Clinical StudyCorrespondence Address :
Dr. NR Rashmi,
Associate Professor, Department of Anaesthesiology and Pain Relief Room no 105, Major OT, Main block, Kidwai Memorial Institute of Oncology, Dr MH Marigowda Road, Bengaluru, Karnataka, India.
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.
Pain relief, Rescue analgesic, Visual analogue scale
Date of Submission: Feb 16, 2021
Date of Peer Review: Feb 25, 2021
Date of Acceptance: Mar 02, 2021
Date of Publishing: Jun 01, 2021
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA
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• Plagiarism X-checker: Feb 16, 2021
• Manual Googling: Mar 01, 2021
• iThenticate Software: Mar 05, 2021 (23%)
ETYMOLOGY: Author Origin
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- Academic Search Complete Database
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