Key result
Epidural ropivacaine plus fentanyl reduces 48-hour post-operative pain ~21% versus ropivacaine alone in gynecological surgery.
Why the study?
Does continuous epidural infusion of ropivacaine with fentanyl improve post-operative analgesia and ambulation compared to ropivacaine alone in patients undergoing major gynecological surgeries?
RCT (n=60)
Double-blind
Sealed envelope method
No
Does continuous epidural infusion of ropivacaine with fentanyl improve post-operative analgesia and ambulation compared to ropivacaine alone in patients undergoing major gynecological surgeries?
Absolute Event Rate: 2.7% vs 3.4%
p-value: p=0.0016
Continuous epidural infusion of ropivacaine with fentanyl provides better post-operative analgesia than ropivacaine alone in major gynecological surgeries without increasing side effects or impairing ambulation.
Supports fentanyl addition to ropivacaine epidurals for better post-operative analgesia in major gynecological surgery; confirms RCT benefit without compromising ambulation.
Background: To compare the effect of continuous epidural infusion of ropivacaine versus ropivacaine-fentanyl for post-operative analgesia and ambulation in patients undergoing major gynaecological surgeries.Methods: A total of 60 patients of age 20 to 50 yrs of body mass index (BMI) within normal range (18.5to24.9 kg/m2) posted for major gynecological surgeries were divided into two equal groups (Group R and RF) in a prospective, randomized, double-blind fashion. In Group RF (n=30) 0.1% Ropivacaine with 2µg/ml Fentanyl and in Group R (n =30) 0.1% ropivacaine were used. General anaesthesia was given to all patients. Continuous epidural infusion using elastomeric pump was started at ‘0’ post-operative hours at 6ml/hour. Post -operative pain (Visual Analogue Scale Score), ambulation (James Modified Bromage Scale) and side effects were noted at 0, 2, 4, 6, 12, 18, 24, 36 and 48hrs.Results: The differences in VAS Score of subjects of both the groups were statistically significant(p<0.05) at 18 hrs, 24hrs, 36hrs and 48 hrs and the differences in Modified Bromage Scale of subjects of the groups were statistically similar at most of the time intervals. Also, the side effects were statistically similar between the groups.Conclusions: Author concluded that ropivacaine-fentanyl is better than ropivacaine alone by continuous epidural infusion for post-operative analgesia in major gynecological surgeries with no statistically significant side effects, effect on ambulation being similar in both the groups.
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Pathak et al. (2018) conducted an RCT in Major gynecological surgery (n=60). Ropivacaine with fentanyl vs. 0.1% ropivacaine at 6ml/hour was evaluated on Visual Analogue Scale (VAS) score for pain at 48 hours (p=0.0016). Continuous epidural infusion of ropivacaine with fentanyl significantly reduced post-operative pain scores at 48 hours compared to ropivacaine alone (VAS 2.7 vs 3.4, p=0.0016) in patients undergoing major gynecological surgery.
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