COMPARISON OF ANALGESIC EFFECT OF EPIDURAL ROPIVACAINE (0.2%) AND ROPIVACAINE (0.2%) WITH FENTANYL (4mcg/ml) IN POST OPERATIVE PATIENT OF TOTAL KNEE REPLACEMENT SURGERY

Introduction: Epidural anesthesia is the most commonly used technique for providing not only peri-operative surgical anesthesia but post-operative analgesia in lower abdominal and limb surgeries. Our study aimed to assess the comparison between ropivacaine(Group A) and combination of ropivacaine with fentanyl (Group B) in terms of their analgesic effect, hemodynamic stability, side effects and requirement of rescue drug in post operative patient of total knee replacement surgery. Materials and methods: After surgery, Pulse rate, systolic and diastolic blood pressure, Sp02, visual analogue score and requirement of other analgesics was studied at every 30 minutes for 2 hrs, then hourly up to 12 hrs and every 2 hourly thereafter up to 24 hrs in group A and Group B. Patients were also observed for side effects. Statistically significant when the p <0.05 and highly significant if p<0.001. Results:  In our study, there was no significant difference amongst the groups in respect to age, sex distribution, height and ASA physical status. There was no statistically significant difference in pulse rate, blood pressure and SpO2 at baseline between the two groups. In our study we observed that VAS scores were found to be better at all time during 24 hours observation in group B. No difference was found between the two groups, in terms of other side effects. Discussion: We observed that the need for rescue analgesia required higher in group A.  So in our study requirement of rescue drug was significantly less with addition of fentanyl. In conclusion, our study has demonstrated that addition of fentanyl to ropivacaine decreased postoperative pain with stable vital signs in patients undergoing total knee replacement surgery, as compared to ropivacaine alone. Also the need for rescue analgesia was decreased with Group B.