SO SÁNH HIỆU QUẢ GIẢM ĐAU NGOÀI MÀNG CỨNG BỆNH NHÂN TỰ ĐIỀU KHIỂN BẰNG HỖN HỢP ROPIVACAIN – FENTANYL VỚI BUPIVACAIN - FENTANYL SAU PHẪU THUẬT BỤNG

Abstract

Objective: To compare the postoperative analgesic efficacy of patient-controlled epidural analgesia using a mixture of 0.125% ropivacaine - 2 μg/ml fentanyl (RF group) versus 0.125% bupivacaine - 2 μg/ml fentanyl (BF group) after abdominal surgery. Subjects and Methods: This is a controlled clinical intervention study involving 82 patients using PCEA for postoperative pain relief after upper abdominal surgery at Nghe An General Friendship Hospital from February 2022 to August 2022. Results: The average VAS score at rest at H0/H0.5 in the RF group was 6.29±1.03/1.83±0.67, while in the BF group it was 6.17±0.83/1.73±0.59. During movement, the corresponding scores were 6.66 ± 0.94/3.41 ± 0.92 in the RF group and 6.59 ± 0.89/3.44 ± 0.86 in the BF group. The total number of analgesic requests in the RF group was 19.71 ± 8.91, which was higher than in the BF group (18.71 ± 5.55). The number of requests over 3 days ranged from a minimum of 10 to a maximum of 43. The average rate of successful pain relief requests was higher in the BF group compared to the RF group. Postoperative time to first bowel movement and postoperative hospital stay were 40.56±4.19 hours/8.95±1.34 days for the BF group and 39.63±3.84 hours/8.46±1.38 days for the RF group. The rate of very high satisfaction in the BF group was 65.9%, while it was 75.6% in the RF group. Conclusion: Postoperative pain relief with 0.125% ropivacaine - 2 μg/ml fentanyl and 0.125% bupivacaine - 2 μg/ml fentanyl is highly effective and comparable at rest and during movement. The time to first bowel movement and postoperative hospital stay were longer in the BF group than in the RF group. The level of very high satisfaction was higher in the ropivacaine group than in the bupivacaine group. Both groups achieved at least a satisfactory level of satisfaction