Epidural Analgesia After Lumbar Disc Surgery With Ropivacaine Plus Fentanyl or Bupivacaine Plus Fentanyl

Abstract

We compared the efficacy and safety of continuous epidural infusion of ropivacaine plus fentanyl versus bupivacaine plus fentanyl in the management of postoperative pain after lumbar laminectomy. Twenty-two patients who underwent elective lumbar laminectomy were randomly allocated to one of two groups. The patients were treated with ropivacaine 0.1% plus fentanyl 2 μg/ml in group 1, and with bupivacaine 0.1% plus fentanyl 2 μg/ml in group 2 via bolus epidural infusion (6-10 ml/h). General anesthesia was standardized. Postoperative pain was evaluated using VAS at 0, 1, 2, 3, 8, 20, 32, 48 hours after surgery. The amount of ropivacaine plus fentanyl or bupivacaine plus fentanyl used over the 48-h postoperative period was documented. The postoperative pain and sedation scores were not significantly different between groups throughout the study period. The total consumption of ropivacaine plus fentanyl over the 48-h period was significantly lower (p < 0.05) than that of bupivacaine plus fentanyl. There was no difference in the incidence of side effects. No patient developed respiratory depression or wound infection. We conclude that the use of ropivacaine-fentanyl mixture for patient epidural analgesia after lumbal disc surgery provides similar succesful pain relief as bupivacaine plus fentanyl, but patients receiving bupivacaine-fentanyl need a higer dose. © 2005 VSP.