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EVALUATION OF CIRCULATORY, RESPIRATORY EFFECTS AND OTHER ADVERSE EFFECTS OF PATIENT-CONTROLLED THORACIC EPIDURAL ANALGESIA USING COMBINATION OF ROPIVACAINE AND FENTANYL FOR PATIENTS UNDERGOING OPEN ABDOMINAL SUGERY
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Abstract
Objectives: To evaluate the side effects of postoperative patient-controlled epidural analgesia using the combination of ropivacaine and fentanyl for open abdominal surgery. Methods: A randomized comparative clinical trial was performed on 3 groups of patients, each of which contained 35 patients with indication for open abdominal surgery. The medications applied for postoperative analgesia were made up of fentanyl 2mcg/ml combined with ropivacaine 0,1% in group I, ropivacaine 0,125% in group II and ropivacaine 0,2% in group III. The adverse effects of postoperative analgesia within 72 hours after surgery were documented. Results: The heart rate of patients in both the 3 groups considerably reduced within the first 15 min after surgery, but then remained stable from the thirteenth minute and then. The average respiratory rate of patients in the study diminished from 18,3 ± 14 to 16,3 ± 0,9 (cycle/min). No patient suffered from oxygen desaturation with SpO2 of lower than 95%. In both three groups, the average time until postoperative fart was less than 40 hours, and the average time of the ability for the postoperative sitting position was less than 20 hours. Side effects were headache, nausea, and vomiting with low proportion (<5%) There were no patients experiencing epidural catheter dislodgement, hypotension, pruritus, or shivering. Conclusion: The circulatory and respiratory parameters of all patients fluctuated within normal ranges, thereby substantially ameliorating the incidence of adverse effects.
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Keywords
ropivacaine, fentanyl, thoracic epidural anesthesia, open-abdominal surgery
References
2. Trần Đức Thọ (2017), Nghiên cứu tác dụng giảm đau sau mổ bụng trên của Levobupivacain phối hợp với Sufentanil hoặc Fentanyl hoặc Clonidin qua catheter ngoài màng cứng bệnh nhân tự điều khiên, Luận án Tiến sĩ Y học, Viện nghiên cứu Khoa học Y Dược Lâm sàng 108.
3. Clemente A., Carli F. (2008), "The physiological effects of thoracic epidural anesthesia and analgesia on the cardiovascular, respiratory and gastrointestinal systems", Minerva Anestesiol. 74(10), p. 549-63.
4. Hansdottir V., et al (2006), "Thoracic epidural versus intravenous patient-controlled analgesia after cardiac surgery: a randomized controlled trial on length of hospital stay and patient-perceived quality of recovery", Anesthesiology. 104(1), p. 142-51.
5. Jain Rashmi, Gupta Pushpalata, Jain Vinita (2016), "A comparison of ropivacaine with fentanyl to bupivacaine with fentanyl for post-operative patient controlled epidural analgesia in patients undergone lower abdominal cancer surgery", J IAIM. 3(7), p. 137-149.
6. Patil Shruti Shrikant, Kudalkar Amala G., Tendolkar Bharati A. (2018), "Comparison of continuous epidural infusion of 0.125% ropivacaine with 1 μg/ml fentanyl versus 0.125% bupivacaine with 1 μg/ml fentanyl for postoperative analgesia in major abdominal surgery", Journal of anaesthesiology, clinical pharmacology. 34(1), p. 29-34.
7. Scott N. B., et al (1996), "Continuous thoracic epidural analgesia versus combined spinal/thoracic epidural analgesia on pain, pulmonary function and the metabolic response following colonic resection". 40(6), p. 691-696.
8. Yvan Pouzeratte., Jean M. Delay., Georges Brunat. (2001), "Patient-Controlled Epidural Analgesia After Abdominal Surgery: Ropivacaine Versus Bupivacaine", Anesth Analg. 93, p. 1587-1592.
9. Zafar N., et al (2010), "The evolution of analgesia in an 'accelerated' recovery programme for resectional laparoscopic colorectal surgery with anastomosis", Colorectal Dis. 12(2), p. 119-24.