BACKGROUND: The lower levels of cardiotoxicity and motor block make ropivacaine well suited as an epidural infusion for postoperative analgesia. This study examined the analgesic efficacy of an epidural infusion of ropivacaine alone and in combination with alfentanil after major abdominal surgery.

METHODS: Thirty patients undergoing major abdominal surgery under general anesthesia were divided into two groups receiving patient-controlled thoracic epidural analgesia with 0.2% ropivacaine (Group I) and 0.15% ropivacaine +150 µg/ml alfentanil (Group II). The motor block, side effects, VAS (visual analog pain scale) score on coughing and resting, additional analgesics use, and patient's satisfaction were checked for 24 hours after a loading dose injection.

RESULTS: The VAS score in group II was significantly lower than in group I, and the patients in group II were more satisfied than those in group I (P < 0.05). However, there were more side effects in group II.

CONCLUSIONS: Postoperative epidural infusion of 0.15% ropivacaine with 150 µg/ml alfentanil is more effective than 0.2% ropivacaine only.