References

IJMABHR

International Journal of Medical and All Body Health Research

IJMABHR

2582-8940

Anfo Publication House

381

10.54660/IJMBHR.2025.6.3.178-185

Comparison of Continuous Epidural Infusion of 0.125% Ropivacaine with 1 mcg/ml Fentanyl versus 0.125% Bupivacaine with 1 mcg/ml Fentanyl for Postoperative Analgesia in Major Abdominal Surgery

Maheshwari

Ketan

Jagar

Keshav Dev

Sharma

Shailja

Sharma

Nikhil

Bhati

Bobi

1Post Graduate Resident, Department of Anaesthesia and Critical Care, Saraswathi Institute of Medical Sciences, Pilkhuwa, Hapur, Uttar Pradesh, India 2Associate Professor, Department of Anaesthesia and Critical Care, Saraswathi Institute of Medical Sciences, Pilkhuwa, Hapur, Uttar Pradesh, India 3HOD and Professor, Department of Anaesthesia and Critical Care, Saraswathi Institute of Medical Sciences, Pilkhuwa, Hapur, Uttar Pradesh, India 4Department of Anaesthesia and Critical Care, Saraswathi Institute of Medical Sciences, Pilkhuwa, Hapur, Uttar Pradesh, India

23072025

6 3 178 185 10062025 11072025

CC BY-NC-SA 4.0

Effective postoperative analgesia is crucial for patient recovery following major abdominal surgery, influencing not only patient comfort but also clinical outcomes including respiratory function, mobilization, and hospital length of stay. This prospective, randomized, double-blind study compared the efficacy and safety of continuous epidural infusion of 0.125% ropivacaine with 1 mcg/ml fentanyl versus 0.125% bupivacaine with 1 mcg/ml fentanyl for postoperative analgesia in patients undergoing major abdominal surgery. One hundred twenty patients aged 18-75 years, ASA physical status I-III, scheduled for elective major abdominal surgery were randomly allocated using computer-generated randomization to receive either ropivacaine-fentanyl combination (Group R, n=60) or bupivacaine-fentanyl combination (Group B, n=60) via continuous epidural infusion at 5-10 ml/hr for 48 hours postoperatively. The epidural catheter was placed at T8-T10 level preoperatively. Primary outcomes included pain scores at rest and during movement, assessed using Visual Analog Scale (VAS) at 2, 6, 12, 24, and 48 hours postoperatively. Secondary outcomes included degree of motor blockade assessed using modified Bromage scale, hemodynamic parameters (blood pressure and heart rate), rescue analgesic requirements, time to first ambulation, patient satisfaction scores, and incidence of adverse events. Both groups demonstrated comparable analgesic efficacy with mean VAS scores at rest ranging from 2.1±0.8 to 3.2±1.1 in Group R and 2.0±0.7 to 3.1±1.0 in Group B (p>0.05 at all time points). VAS scores during movement were also similar between groups. However, Group R showed significantly less motor blockade with only 8.3% of patients experiencing Bromage score ≥1 compared to 21.7% in Group B (p=0.042). Hemodynamic stability was better maintained in Group R with significantly lower incidence of hypotension requiring intervention (13.3% vs 26.7%, p=0.048). Time to first ambulation was shorter in Group R (18.4±4.2 hours vs 22.8±5.6 hours, p

Postoperative AnalgesiaEpidural InfusionRopivacaineBupivacaineFentanylAbdominal SurgeryMotor BlockadePatient Satisfaction

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