Analgesic effect of different concentration of ropivacaine/fentanyl for postoperative patient-controlled epidural analgesia

Objective:To compare the analgesic and side effect of patient-controlled epidural analgesia with two different solutions of ropivacaine/fentanyl after hysterectomy.Methods:Forty ASA Ⅰ-Ⅱ patient undergoing elective hysterectomy under epidural anesthesia were randomly divided into two groups:0.15% ropivacaine- 2μg/ml fentany group (R 1, n =20) and 0.2% ropivacaine-2 μg/ml fentanyl group (R 2, n =20).Patient- controlled epidural analgesia setting for the two solutions:the loadinding doses was 6ml,bolus dose was 5ml,lock-out interval time 20 min and maximal amount within 4 h was 40ml in both groups.The clinical effects were assessed by(1)VAS score of pain (0=no pain,10=severe pain),(2)modified Bromage score,(3)monitoring heart rate and blood pressure after preoperation and analgesia,(4)the time when the patient passed gas and(5)side effect (nausea,vomiting,motor block et al).Results:All two solutions produced equivalent analgesia.Motor block was significantly more common and more intense with the 0.2% ropivacaine-2μg fentanyl solution.Other side effects were equivalent between solutions and mild. Conclution:Our results suggest that 0.15% ropivacaine -2μg fentanyl solution for postoperative PCEA after lower abdominal surgery provides satisfactory analgesia and less motor block.