Efficacy of addition of fentanyl to bupivacaine versus bupivacaine alone on postoperative analgesia in cases undergoing abdominal surgeries

Abstract

Background: Successful selection of a drug for epidural anaesthesia needs an understanding of the anaesthetic potency and estimation of postoperative analgesia requirement. Bupivacaine is a widely used long acting analgesia. The present study was designed to assess the efficacy of bupivacaine alone and bupivacaine with fentanyl in adults cases undergoing abdominal surgeries. Materials and methods: A total 100 cases undergoing abdominal surgeries under general anesthesia between 18-60 years belongs to ASA grade I and II were recruited. Participants were randomly divided in to two study groups i.e. group 1 administered with 0.125% Bupivacaine alone and group 2 administered with 0.125% Bupivacaine with 1mcg/kg fentanyl. Post-operative hemodynamics, respiratory rate, oxygen saturation, postoperative pain assessed by visual analogue pain scale, time for first rescue analgesia and duration of analgesia, Ramsay sedation score and GI complication like nausea/vomiting and pruritus were assessed. Results: The postoperative difference of hemodynamics, respiratory rate and oxygen saturation was comparable between two study groups. The time for first rescue analgesia in group 1 was 103.56 ± 3.38 and in group 2 was 285.55 ± 3.14. The mean difference was statistically significant. The incidence of nausea/vomiting and pruritus was more in group 2 than group 1. VAS score and Ramsay sedation score are comparable in both the study groups. Conclusion: Postoperative epidural analgesia was higher in group 2 than group 1. Epidural infusion of 0.125% Bupivacaine alone is more effective then 0.125% Bupivacaine with 1mcg/kg fentanyl in cases undergoing abdominal surgeries.