A comparative study of epidural ropivacaine 0.2% with nalbuphine and ropivacaine 0.2% with fentanyl in unilateral total knee replacement surgeries

Abstract

Background: Total knee replacement (TKR) is associated with intense early postoperative pain. Epidural opioids have unique advantages over conventional, intermittent IV/ IM administration, in that sooner in the postoperative period. Materials and methods: This is prospective, double blind study where twenty patients in group A received Ropivacaine 0.2% with Nalbuphine and twenty patients in group B received Ropivacaine 0.2% with Fentanyl. Patients were assessed for hemodynamic changes, VAS scores, sedation scores and side effects. Result: There was no statistically significant difference in the baseline parameters between the two groups. Rescue analgesics required in the first 24 hours of postoperative period in group A were significantly higher (p < 0.01) when compared with group B. Nalbuphine group had a good sedative action than Fentanyl group (P=0.04). Conclusion: Fentanyl group is better in terms of quality of postoperative analgesia, lesser incidence of side-effects and patient satisfaction.