Key result
Epidural ropivacaine with fentanyl significantly reduced the need for rescue analgesics in the first 24 hours postoperatively compared to ropivacaine with nalbuphine (p < 0.01).
Why the study?
Total knee replacement is associated with intense early postoperative pain, and epidural opioids offer advantages over intermittent intravenous or intramuscular administration.
Does epidural ropivacaine with nalbuphine compared to ropivacaine with fentanyl improve postoperative analgesia in patients undergoing unilateral total knee replacement?
RCT (n=40)
Double-blind
Randomly chosen
No
Does epidural ropivacaine with nalbuphine compared to ropivacaine with fentanyl improve postoperative analgesia in patients undergoing unilateral total knee replacement?
p-value: p=<0.01
Epidural fentanyl combined with ropivacaine provides superior postoperative analgesia with fewer rescue analgesic requirements compared to nalbuphine with ropivacaine in patients undergoing total knee replacement.
Epidural nalbuphine or fentanyl with ropivacaine may aid early TKR analgesia; leaves open optimal choice and practice change.
Background: Total knee replacement (TKR) is associated with intense early postoperative pain. Epidural opioids have unique advantages over conventional, intermittent IV/ IM administration, in that sooner in the postoperative period. Materials and methods: This is prospective, double blind study where twenty patients in group A received Ropivacaine 0.2% with Nalbuphine and twenty patients in group B received Ropivacaine 0.2% with Fentanyl. Patients were assessed for hemodynamic changes, VAS scores, sedation scores and side effects. Result: There was no statistically significant difference in the baseline parameters between the two groups. Rescue analgesics required in the first 24 hours of postoperative period in group A were significantly higher (p < 0.01) when compared with group B. Nalbuphine group had a good sedative action than Fentanyl group (P=0.04). Conclusion: Fentanyl group is better in terms of quality of postoperative analgesia, lesser incidence of side-effects and patient satisfaction.
No takes yet. Share an insight, caveat, or question.
Shelke et al. (2020) conducted an RCT in Unilateral total knee replacement (n=40). Epidural Ropivacaine 0.2% with Fentanyl vs. Epidural Ropivacaine 0.2% with Nalbuphine (0.13 mg/ml) was evaluated on Requirement of rescue analgesics in the first 24 hours (p=<0.01). Epidural ropivacaine with fentanyl significantly reduced the need for rescue analgesics in the first 24 hours postoperatively compared to ropivacaine with nalbuphine (p < 0.01).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: