EFFICACY OF WOUND INFILTRATION USING BUPIVACAINE VERSUS ROPIVACAINE ALONG WITH FENTANYL FOR POSTOPERATIVE ANALGESIA FOLLOWING ABDOMINAL HYSTERECTOMY UNDER SPINAL ANESTHESIA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2013, Vol 2, Issue 34
Abstract
[b]BACKGROUND[/b]: Wound infiltration with local anesthetics and opioids is increasingly being used as a part of multimodal postoperative analgesia. [b]OBJECTIVES[/b]: A prospective randomized double blind placebo controlled study was conducted to investigate the efficacy of wound infiltration using bupivacaine versus ropivacaine with fentanyl for postoperative analgesia. [b]METHOD[/b]: 93 female patients of ASA grade I/II posted for abdominal hysterectomy under spinal anesthesia were randomly divided into three groups destined to receive wound infiltration at the end of surgery using 14.5 ml 0.5% isobaric solution of either bupivacaine or ropivacaine along with 0.5 ml (25 mcg) fentanyl in group BF and RF respectively, and with 15 ml normal saline in control group (Group S). All patients received diclofenac 75 mg I.M. (B.D.) and rescue analgesic butorphanol 1 mg was given if pain occurs. Postoperative analgesia in terms of visual analogue score rescue opioids consumption in 24 hour period, and satisfaction score of patient, surgeon and anesthesiologist was compared. Rescue opioid (butorphanol) consumption in 24 hours was significantly higher in group S (61 mg), as compared to group BF (21 mg) and group RF (26 mg), p= 0.000. However group BF and group RF were comparable p=0.473. (Group S > group RF~ Group BF). Mean VAS score at rest, cough and movement was significantly less and satisfaction of patient, surgeon and anesthesiologist was significantly higher in group BF than in group RF than in group S, p<0.05. [b]CONCLUSION[/b]: We conclude that wound infiltration using bupivacaine or ropivacaine with fentanyl is an easy, safe and effective technique for providing postoperative analgesia. Moreover, bupivacaine seems to be superior to ropivacaine in wound infiltration in terms of significantly less pain score and better satisfaction score.
Authors and Affiliations
Udita Naithani, Indira Kumari, Rekha Roat, Vinita Agarwal, Chayenika Gokula, Harsha , Vimla Doshi
Keywords
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- EP ID EP153769
- DOI 10.14260/jemds/1162
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