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Category: Volume 05 Issue 08 August 2017
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Title: A Comparative Study of Patient Controlled Epidural Analgesia Using Bupivacaine and Fentanyl v/s IV Fentanyl in Patients for Pain Management in Post Operative Patients with Abdominal Surgeries

Authors: Rita Upadhyay, Ashish Sethi, Mayank Chansoriya

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i8.130

Abstract

Patient Controlled Analgesia is system used in postoperative pain relief which enables patients to self titrate analgesia to their desired pain relief .This study has been a prospective study where patients were randomly allocated into two groups (30 patients each).Group A- Patients given general anaesthesia and post operative intravenous fentanyl (IV group).Group B- Patients given general anaesthesia and epidural catheter placed where  post operative  pain was managed with patient controlled epidural analgesia using fentanyl and bupivacaine (PCEA group).All patients received verbal and written instructions on the use of PCEA  after taking informed consent . In IV Group:-The first dose of fentanyl (50 mcg ) was given on first analgesic request and then iv fentanyl 50 mcg repeated every 4 hrs post operatively. PCEA Group: Epidural analgesia provided by post operative administration of  0.125% bupivacaine and 5 mcg/ml fentanyl mixture using a PCEA pump programmed to deliver 1 ml bolus with a lock out interval of 20 minute and a background infusion of 2 ml per hour. The cumulative fentanyl dose recorded during the 24 hrs of the study. Postoperatively, the vital parameters, pain score and the side-effects of fentanyl were recorded at regular intervals for 24 hours. The overall pain scores were significantly lower in the PCEA group when compared to the IV group. The current study showed that postoperative PCA techniques by the epidural is more effective when compared with the parenteral route.

Keywords:- Pain,Patient Controlled Analgesia,Patient Controlled Epidural Analgesia, Fentanyl, Bupivacaine, lock out interval.

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Corresponding Author

Rita Upadhyay

A-87, Samdariya Residency, Shatabdipuram, Vijay Nagar,

Jabalpur, India 482003 Mobile No. 9179137714