Prolonged epidural infusions of ropivacaine [2 mg/mt) after colonic surgery: The impact of adding fentanyl

We evaluated the safety and efficacy of a 72-h epidural infusion of ropivac aine and measured the impact of adding fentanyl 2 mug/mL to the required in fusion rate, on the quality of postoperative pain relief and the incidence of side effects, after colonic surgery. One hundred fifty-five patients sch eduled for elective colonic surgery were randomized in this trial. Epidural infusions of ropivacaine 2 mg/mL with fentanyl 2 mug/mL (R + F) and withou t fentanyl (R) were commenced during surgery and continued for 72 h postope ratively. This was a prospective, randomized, double-blinded, multi-center trial. The median infusion rate required was less in the R f F group (9.3 v s 11.5 mL/h, P < 0.001). Median pain scores at rest and on coughing were lo wer in the R + F group (P < 0.0001). The incidence of hypotension was more in the R + F group (P = 0.01). Time to readiness for discharge was delayed in the R f F group (median 6.6 vs 5.5 days, P = 0.012). The addition of fen tanyl to ropivacaine resulted in decreased infusion rates and enhanced pain control; however, adverse effects were increased and readiness to discharg e was delayed.