Epidural continuous infusion of fentanyl-bupivacaine and meperidine, bupivacaine for postoperative pain control

Abstract

Objective. This study was designed to compare the analgesic effectiveness of continuous epidural infusion between the combination on fentanyl bupivacaine and meperidine-bupivacaine for the treatment of pain after major orthopaedic operations. Methods. A total of 40 patients, ASA I-II, who scheduled for major orthopaedic operations were divided randomly into two groups (A-B). Both groups had an epidural catheter placed into the interspace of T12-L5. Ten of these patients had their operations under general anaesthesia. For postoperative pain control: In Group A: a mixture of Bupivacaine 0.125% and Fentanyl 10 mcg/ml and in Group B Bupivacaine 0.125% and Meperidine 2.5 mg/ml solutions were given epidurally by continuous infusion. The infusion rate was 6-8 ml/h for both groups. Blood pressure, heart rate, respiratory rate, Visual Analogue Score (VAS) and infusion rate were determined at early, 1st, 4th, 24th, 48th and 72nd. hours postoperatively. Results. No significant differences were observed regarding blood pressure, heart rate, respiratory rate and infusion rate in both group. However pain score (VAS) diminished significantly in Group A. The patients in Group B were more likely need to be treated for nausea-vomiting and urinary retention. Conclusion. As a result of this study we concluded that epidural continuous infusion of fentanyl-bupivacaine showed better analgesic quality than meperidine-bupivacaine with no side effects in orthopaedic procedures.