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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
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