A Comparative Study of 0.25% Ropivacaine And 0.25% Bupivacaine Along With Fentanyl for Postoperative Epidural Analgesia in Patients Undergone Lower Abdominal and Lower Limb Surgeries

Abstract

Background: To compare onset and duration of analgesia and hemodynamic changes between 0.25% Ropivacaine and 0.25% Bupivacaine along with 25ug fentanyl in 60 patients, who underwent elective lower abdominal and lower limb surgeries. Aim: This study has been conducted to compare:  The onset and duration of postoperative analgesia & the hemodynamic changes Methods: Randomly divided into 2 groups, Group R and Group B, of 30 each. Group r – Receiving 10ml of 0.25 % Ropivacaine with 25μg of inj.Fentanyl Group b – Receiving 10 ml of 0.25% Bupivacaine with 25μg of inj.Fentanyl. Results: The mean onset of sensory block was significantly lower (quicker) in Group B compared to group R (4.63 vs 6.03). Significantly higher in group B (301.3 min. vs. 187.2 min) compared to group R (P<0.001;S).The mean diastolic blood pressure was similar in group B and group R for all time periods up to 120 minutes. it was significantly lower in group B (78.4 ± 4.79) compared to group R (81.2 ± 3.46) at 180 minutes (P<0.001; S). The mean respiratory rate was similar in group B and group R for all time periods upto 120 minutes.it was significantly lower in group B (13.1) compared to group R (14.4) at 180 minutes (P<0.001; S). The mean VAS was similar at the start of procedure but was significantly lower in group B after 10 minutes (3.50) compared to group R (3.98). It remained similar at 20 min but fell significantly lower in group R compared to group B(1.63 vs 2.03) while it remained similar at 60 and 120 minutes. at 180 minutes, the score was very highly significantly lower in group B (0.60) compared to that in group R (4.80) (P<0.001; S). The mean sedation score (SS) was similar in group B and group R for all time periods up to 120 minutes. it was significantly lower in group B (3.00) compared to group R (3.96) at 180 minutes (P<0.001; S). Conclusion: It was concluded that 1. Bupivacaine had a slightly faster(quicker) onset of action. 2. Duration of analgesia was longer and better in Group B patients who received bupivacaine with fentanyl. 3. Hemodynamic stability was more with Ropivacaine. 4. Patients who received 0.25% Bupivacaine with fentanyl had some degree of motor blockade, whereas 0.25% Ropivacaine with fentanyl didn’t cause any motor blockade in patients in Group R. so faster mobility and early rehabilitation was observed in patients who received 0.25% ropivacaine with fentanyl due to its decreased potency and shorter duration of action.