A Comparative Study of Efficacy of Epidural Ropivacaine (0.2%) and Bupivacaine (0.125%) with Fentanyl (2 mueg/mL) for Postoperative Analgesia in Patients Undergoing Joint Replacement Surgeries

ABSTRACT

Epidural analgesia is an important component of the multimodal approach to pain management. It is used effectively for postoperative pain management following joint replacement surgeries. In this study, we aimed to evaluate the post-operative analgesic efficacy of epidural Ropivacaine (0.2%) – Fentanyl (2 µg/mL) and epidural Bupivacaine (0.125%) - Fentanyl (2 µg/mL) on patients undergoing joint replacement surgeries.METHODS60 adult patients of ASAPS grade I or II between ages 25 - 65 years of either sex undergoing elective joint replacement surgeries were randomly allocated to two groups Group A (ropivacaine group) receiving ropivacaine 0.2% (40 mL) + fentanyl (2 µg/mL) and Group B (bupivacaine group) receiving bupivacaine 0.125% (40 mL) + fentanyl (2 µg/mL).RESULTSThe immediate post-operative VAS scores for pain at rest and on touch of patients in the two groups were close to no-pain status. Mean VAS scores at rest showed an incremental trend with passage of time. At 24 hour postoperative interval, mean VAS score at rest was 3.13 ± 0.43 in group A and 3.10 ± 0.40 in group B while mean VAS score on touch was 3.20 ± 0.55 in group A and 3.40 ± 0.68 in group B. Statistically, there was no significant difference between the two groups at any of the follow-up intervals. Thus, as far as analgesic effect of the two drugs was concerned, both the drugs have comparable efficacy in terms of mean VAS scores. In the present study, median VAS scores peaked at 6-hour postoperative interval and remained at same level till the end of study.CONCLUSIONSIn our study, both ropivacaine (0.2%) and bupivacaine (0.125%) with fentanyl (2 µg/mL) combinations showed similar efficacy in postoperative pain management with almost stable hemodynamic profile. Moreover, the ropivacaine group gives better motor blockade and lower overall rescue analgesic needs.