Comparison of clinical efficacy of bupivacaine-fentanyl with ropivacaine-fentanyl in patients undergoing abdominal and pelvic procedures

Abstract

Background: The pain after major abdominal surgeries, if treated inadequately, may lead to increased postoperative morbidity and delayed recovery. Epidural analgesia is one of the most effective regimens for postoperative analgesia. The present study was undertaken to evaluate and compare the clinical efficacy of bupivacaine-fentanyl with ropivacaine-fentanyl in patients undergoing abdominal and pelvic procedures. Method: Total 80 adult patients of age between 18 to 55 years were enrolled and divided into two groups of 40 patients in each. Group BF received 0.5% bupivacaine for epidural block with Fentanyl 25 micro gm and Group RF received 0.75% ropivacaine for epidural block with Fentanyl 25 micro gm. Results: Two groups were statistically similar for demographic profile and duration of surgery, (p>0.05). In both the groups, majority of patients were undergoing abdominal surgery (BF-55% vs. RF- 60%) compared to pelvic surgery (BF-45% vs. RF-40%), (p = 0.821). There was no significant difference between two groups with respect to haemodynamic parameters (HR, SBP, DBP, MAP and SpO2) and respiratory rate at different perioperative intervals. Higher time to request first rescue analgesic in patients received ropivacaine-fentanyl (RF group), which was statistically significant. Also the duration of analgesia was longer in RF group (176.73 ± 11.13) than BF group (170.98 ± 8.60), (p = 0.012). Incidence of nausea, vomiting, hypotension and bradycardia were comparable between two groups.Conclusion: The epidural infusion of 20 ml of 0.75% ropivacaine with fentanyl 25μg provides adequate anesthesia for lower abdominal and pelvic surgeries, also it provides longer intraoperative and postoperative analgesia with hemodynamic stability compared with bupivacaine 0.5% with fentanyl.