Comparison of efficacy of Bupivacain and Fentanyl in Pre-emptive and Pre-ventive Epidural Analgesia in the patients undergoing Major Gynecologic Surgeries.

Our aim in this study is to compare efficacy of epidural administration of analgesics before the initiation of the surgery with adminstration before the end of surgery in patients undergoing major gynecologic surgeries. Key inclusion criteria is to be over 18 years with an indication for major gynecologic surgery. Main exclusion criteria are having a contraindication for epidural analgesia and to have allergy to analgesics. 50 females over 18 years candidate for major gynecologic surgery in Tabriz Al-Zahra hospital will be divided into two groups of 25. For the patients in group 1, as the group pre-emptive, 20 minutes before the initiation of the surgery, 25 micrograms of fentanyl and 10-12 ml of bupivacain 0.125 as a bolus dose prior to continuous infusion of bupivacain 0.125 with rate of 2ml per minute, would be administered. For the patients in group 2, as group pre-ventive, a bolus dose of 10-12 ml of Bupivacain 0.125 and fentanyl 25 micrograms would be administered 20 minutes before the end of surgery via epidural catheter. All the patients would be admitted to intensive care unit when fully awakened. Administered analgesics dose together with pain scores via visual analogue scale from 0 (without pain) to 10 (with an intolerable pain), as primary outcome measures, would be measured immediately after consciousness (hour 0) and 3, 6, 12 and 24 hours later for the two groups to be compared.

Tabriz University of Medical Sciences