AbstractBackground: This study was carried out to assess the efficacy of epidural Fentanyl as intraoperative and postoperative analgesia when used along with bupivacaine epidurally. Materials and Methods: After taking the informed consent, 100 patients of ASA Grade 1 and 2 scheduled for elective lower abdominal or lower limb surgeries were randomly allocated into one of these two groups of 50 each. Group 1 patients received 15 ml of 0.5% bupivacaine by epidural route followed by 3 ml of boluses of bupivacaine after every 5 minutes if required till T10 level was achieved before start of surgery. Group 2 received 15 ml of bupivacaine with 1-2 µgm/kg of body weight fentanyl by epidural route followed by 3 ml of boluses of bupivacaine after every 5 minutes if required till T10 level was achieved before start of surgery. Both the groups were demographically similar and did not differ in term of pre-operative hemodynamics and mean duration of surgery. Patients were monitored for pain relief by VAS score and also hemodynamic and respiratory parameters were monitored both intraoperatively and for 3 hours in post-operative period. Results: The onset and maximum upper level of analgesia in Group 2 was statistically significant. The duration of analgesia in group 1 was less than group 2 and was found to be statistically significant. The mean of VAS in group 1 was 49.20±18.61 and in group 2 was 27.40±23.80 and this was found to be statistically significant. The sedation score was found to be statistically significant in group 2. Conclusion: Epidural fentanyl when added with epidural bupivacaine improves the quality, onset and duration of analgesia without causing any increase in intraoperative and post-operative complications.
Keywords: Epidural; Post-operative analgesia; Fentanyl; Bupivacaine.