Original Research Article
Year: 2019 | Month: May | Volume: 6 | Issue: 5 | Pages: 1-9
Evaluation of Epidural Buprenorphine for Postoperative Analgesia for Below Umbilical Surgical Procedures
Anuradha Malliwal
Professor, Department of Anaesthesiology, Terna Medical College, Navi Mumbai, Maharashtra-400706.ABSTRACT
Introduction: Epidural analgesia with local anaesthetics is extremely effective in controlling postoperative pain, but its use has been limited by concerns about possible hypotension, tachyphylaxis, systemic toxicity, technical difficulty with insertion of an epidural catheter and problems of postoperative surveillance. Addition of opiates to epidural local anaesthetic avoids many of these side effects. Buprenorphine, as an additive is attractive choice since it is not a controlled drug, has minimum addition potential, is marketed preservative-free and provides a long duration of action with minimum side effects. A prospective study was conducted to evaluate the efficacy of epidural buprenorphine for postoperative analgesia in patients undergoing surgical procedures below the umbilicus under epidural anaesthesia.
Materials & Methods: Sixty patients of either sex, 20-50 years of age, belonging to ASA grade I, undergoing surgical procedures below the umbilicus under epidural anaesthesia were randomly allocated to two groups of 30 patients each. Group I: Patients receiving only local anaesthetic epidurally. Group II: Patients receiving a combination local anaesthetic with buprenorphine, 3µg/kg body weight, epidurally, 15mins prior to surgery. Pulse rate, blood pressure, respiratory rate and pain scores were monitored. Incidence of side effects was noted.
Results: Buprenorphine, 3µg/kg, added to local anaesthetic provided good intensity and significantly longer duration of analgesia, as compared to the local anaesthetic group. The most common side effects observed were sedation and nausea and vomiting. While the degree of sedation which occurred was welcome, nausea and vomiting responded very well to anti-emetics.
Key words: epidural analgesia, local anaesthetic, additive, opiates, buprenorphine
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