Comparison of 0.75% Epidural Ropivacaine with and without Fentanyl for Prolongation of Postoperative Analgesia in Adults for Elective Lower Limb Orthopaedics Surgery- An Observational Study

Introduction: Epidural analgesia is an effective postoperative analgesia for surgical procedures. The use of Ropivacaine with adjuvant like Fentanyl is a newer development in the neuraxial blockade and the studies are scarce, so this study to compare the onset and duration of motor and sensoryblockade, efficacy of post-operative analgesia and side-effects seen with 0.75% Ropivacaine with Fentanyl and 0.75% Ropivacaine without any adjuvant in adult lower limb orthopaedics surgery. 

Method: 84 patients were divided into two groups of 42 each. Group RF received 15ml of 0.75% Ropivacaine plus 50micrograms of Fentanyl (total=16ml) and Group R received 15ml 0.75% Ropivacaine plus 1 cc NS (total = 16ml) epidurally. Duration of sensory and motor block was observed intraoperatively and postoperatively along with pain scores (Visual Analogue Scale VAS) and side effects (nausea, vomiting, bradycardia, hypotension).

Results: The groups were demographically comparable. Duration of sensory block was longer in RF group and so was haemodynamic stability and delayed requirement of rescue analgesia. None of the groups showed any side effects.

Conclusion: We conclude that 0.75% Ropivacaine with Fentanyl provides an excellent post-operative analgesia, with no side effects and stable haemodynamics with good patient satisfaction than 0.75% ropivacaine without adjuvant and can be used effectively in all lower limb surgeries