Abstract
Our aim in this study was to compare the postoperative pain-relieving effects and side effects of epidural infusions with higher concentrations of ropivacaine and dosage of fentanyl. The subjects were 45 patients who underwent upper abdominal surgery under general anesthesia with propofol and a low dose of fentanyl (less than 10μg/kg) combined with epidural anesthesia. At the end of the surgery, continuous epidural infusion of 0.2mg fentanyl in 92ml 0.2% ropivacaine (Group B, n=15), or 0.3mg fentanyl in 90ml 0.2% ropivacaine (Group F, n=15) or 0.2mg fentanyl in 92ml 0.3% ropivacaine (Group R, n=15) was started at a rate of 4ml/h for 24hrs. Postoperative analgesic effects were evaluated by the number of demands for supplemental analgesic, VAS at rest and on coughing at 4, 12 and 24hrs postoperatively, and patients' attitudes to postoperative pain relief. VAS on coughing in Groups F and R were significantly less than that of Group B at 12 and 24hrs after the operation. Hypotension occurred in 4 patients in both the F and R groups, while there was no incidence, of hypotension in the B group. We concluded that the change from 0.2% to 0.3% epidural ropivacaine, and the increased dosage of epidural fentanyl from 0.2mg/day to 0.3mg/day, were similarly effective for postoperative analgesia.
