Comparative evaluation of postoperative analgesic efficacy of epidural bupivacaine with fentanyl versus intravenous patient-controlled

Abstract

Background and Objective: Effective postoperative pain management is crucial for optimal recovery. Epidural analgesia using local anesthetics with opioids and intravenous patient-controlled analgesia (IV PCA) are commonly employed techniques. This study aims to compare the analgesic efficacy, side effects, and patient satisfaction between epidural bupivacaine with fentanyl and IV PCA in patients undergoing major abdominal surgery. Materials and Methods: A prospective, randomized study was conducted on 50 patients aged 18-65 years undergoing elective abdominal surgery under general anesthesia. This study was conducted at the department of Orthopedics, Dhanlakshmi Srinivasan Medical College and Hospital, Perambular, Tamil Nadu, India from July 2018 to June 2019. Patients were randomly divided into two groups (n=25 each): Group E received epidural 0.125% bupivacaine with fentanyl (2 µg/mL), while Group I received IV PCA with morphine. Postoperative pain scores using the Visual Analog Scale (VAS), total analgesic consumption, incidence of side effects, and patient satisfaction scores were assessed at 2, 6, 12, and 24 hours postoperatively. Results: Group E showed significantly lower VAS scores at all time intervals compared to Group I (p