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Aim: The primary aim of the study was to compare epidural ropivacaine with fentanyl and epidural bupivacaine with fentanyl for postoperative epidural analgesia after total knee arthroplasty (TKA). The secondary objective was to assess the outcomes of passive and active mobilizations postoperatively, requirement of rescue analgesia, and adverse effects, such as nausea vomiting, sedation, numbness, motor weakness, hypotension, and respiratory depression. Materials and methods: After obtaining hospital ethics committee approval and written informed consent, 100 patients were randomly allocated to two groups of 50 each. Group B received 0.125% bupivacaine with fentanyl (2 μg/mL) epidurally for postoperative pain relief. Group R received 0.2% ropivacaine with fentanyl (2 μg/mL) epidurally for postoperative pain relief. Patients of American Society of Anesthesiologists (ASA) grades I to II of both sexes undergoing elective TKA and giving written consent were included in the study. Patients with coagulation disorders, history of spine surgery, vertebral deformities, and having contraindications for spinal analgesia were excluded from the study. All patients were preoperatively assessed and clinically evaluated thoroughly. They received conventional combined spinal epidural anesthesia followed by epidural infusion in the postoperative period of ropivacaine fentanyl or bupivacaine fentanyl as per the allocation. The postoperative epidural analgesia was supplemented with intravenous (IV) paracetamol 1 gm TDS, and rescue analgesia, if needed, was given with IV tramadol 50 mg. All patients were monitored for postoperative pain by the visual analog scale (VAS), requirement of rescue analgesia, hemodynamic parameters, sedation scores, and adverse effects.

research and innovation in anesthesia

Comparison of Ropivacaine with Fentanyl vs Bupivacaine with Fentanyl for Postoperative Epidural Analgesia in Total Knee Arthroplasty: A Prospective, Randomized, Single-blinded Controlled Study