Abstract
We examined the effects of bupivacaine added to epidural fentanyl and a difference in the volume of fentanyl solution alone on postoperative pain relief in patients who had undergone lower abdominal surgery, and a difference in the volume of solution in the case of fentanyl alone.
Method: Sixty-eight patients received O2, nitrous oxide, sevoflurane and epidural local anesthetics during surgery, and epidural injection of fentanyl 50μg with saline 4ml at the end of surgery. The patients were allocated to three groups and fentanyl 20μg/h was given together with the following: Group B, 0.2% bupivacaine 2ml/h; Group S2, saline 2ml/h; Group S0.5, saline 0.5ml/h. We recorded the analgesic scores and side effects 0, 2, 6, 12, 18, 24 and 48h after surgery.
Results: There were no significant differences in the analgesic score or the frequency of requests for supplemental analgesics between group B and group S2. The analgesic score in the group S0.5 was significantly lower than that in the group B and group S2 (p<0.05). Two patients (9%) in the group B complained of lower limb numbness after 6hour operation. Neither severe hypotension nor severe respiratory depression was observed in any patient, but somnolence was revealed in about 20% patients.
Conclusion: Addition of 0.2% bupivacaine to epidural fentanyl 20μg/h had no advantageous effect on postoperative analgesia. Analgesic effect of epidural fentanyl in 2ml/h was significantly stronger than that of fentanyl in 0.5ml/h.
