Patient-controlled epidural analgesia after abdominal surgery: Ropivacaineversus bupivacaine

In this randomized, double-blinded study we sought to assess the analgesic efficacy of ropivacaine and bupivacaine in combination with sufentanil and the efficacy of ropivacaine alone after major abdominal surgery. Sixty pati ents undergoing major abdominal surgery received standardized general anest hesia combined with epidural thoracic analgesia. They were allocated to one of three groups: the BS group received postoperative patient-controlled ep idural analgesia with 0.125% bupivacaine plus 0.5 mug/mL sufentanil; the RS group received 0.125% ropivacaine plus 0.5 mug/mL sufentanil; and the R gr oup received 0.2% ropivacaine, with the patient-controlled epidural analges ia device set at bolus 2-3 mL and background infusion 3-5 mL/h. Visual anal og scale scores were significantly lower during coughing in the BS group co mpared with the RS and R groups and in the RS group compared with the R gro up. The BS group required significantly less local anesthetic (milligrams p er day) during the first three postoperative days compared with the RS and R groups, and the RS group, significantly less than the R group. No major s ide effects were noted in any group. We conclude that, after major abdomina l surgery, thoracic epidural analgesia was more effective with bupivacaine than with ropivacaine when these two local anesthetics are used in a mixtur e with sufentanil. Ropivacaine alone was less effective than ropivacaine in combination with sufentanil.