[Ropivacaine or its combination with fentanyl for postoperative patient-controlled epidural analgesia]

To investigate the pain-relieving effects of ropivacaine or its combination with fentanyl in postoperative patient-controlled epidural analgesia.

Sixty patients (ASA class I to II) scheduled for elective upper abdominal surgery were randomly divided into 4 groups (15 in each group) to receive 2.0 mg/ml ropivacaine (group R), 1.25 mg/ml ropivacaine plus 1.0 microg/ml fentanyl (group RF1), 1.0 mg/ml ropivacaine plus 2.0 microg/ml fentanyl (group RF2), and 1.0 mg/ml ropivacaine plus 4.0 microg/ml fentanyl (group RF4) respectively for patient-controlled analgesia. The bolus injection was set at 3.0 ml, lockout interval at 20 min, and background epidural infusion at 5.0 ml/h. Before and at 0, 6, 12, 24 and 48 h after the surgeries, the data including mean arterial pressure (MAP), heart rate (HR), cumulative consumption volume (CCV) of analgesic solution and visual analog scale (VAS) scores were recorded, observed and the adverse effects such as vomiting, nausea, pruritus, as well as the time of first excretion of intestinal gas.

Compared with group R, significantly smaller CCV occurred in groups RF2, RF4 (P<0.01), and RF1 (P<0.05) at each time points postoperatively. No significant differences were noted between the groups in VAS scores.

The 4 preparations are comparable in terms of analgesic efficacy and adverse effects, but in groups RF2 and RF4, the smaller doses have sufficed the needs.