Clinical Observation Of Ropivacaine With And Without Fentanyl In Epidural Analgesia After Colorectal Cancer Surgery

Objective: To assess the differences of effect and adverse reactions in epidural analgesia between ropivacaine with and without fentanyl after colorectal cancer surgery.Methods: Eighty-four patients scheduling for elective open colorectal surgery under general anesthesia and epidural analgesia were randomly assigned to group A(0.125% ropivacaine)and group B(0.125%ropivacaine+1ug/ml fentanyl)in postoperative epidural analgesia(PCEA).Using visual analog score(VAS)during rest,deep breathing,cough,and movement to assess Postoperative pain intensity,effective pressing numbers of PCA,mean time to first flatus and adverse effects were recorded at 12,24 and 48 hours after surgery.Results: The VAS of patients in group B was significantly better than that in group A.In the resting and exercise(deep breathing,coughing)state,the VAS scores of patients in group B at 0-12 h and 12-24 h after surgery were significantly lower than those in group A(P <0.05).There were no significant differences in VAS scores between 24-48 hours after surgery.Comparing the number of postoperative PCA between the two groups of patients,the number of PCA in group B was significantly lower than that in group A(2.8 ± 3.5 vs 5.3 ± 5.4,P <0.05).There were no significant differences in postoperative nausea and vomiting between the two groups,but in terms of the need for intravenous remedial pain medication after surgery,the number of patients in group A was significantly larger than that in group B(P <0.05).There was no significant difference in the first exhaust time of the two groups.Conclusion: Ropivacaine combined with 1ug/ml fentanyl in abdominal PCEA had better analgesic effect than ropivacaine alone,with no significant effect on postoperative complications such as intestinal function,nausea and vomiting.