A comparison of the incidence of pruritus following epidural opioid administration in the parturient

Ackerman, William E.; Juneja, M. M.; Kaczorowski, David M.; Colclough, George W.

doi:10.1007/bf03005335

Cited by 53 publications

(24 citation statements)

References 12 publications

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“…Previous studies show the incidence of pruritus after epidural administration of 50 mcg fentanyl was 47% and with 300 mcg Buprenorphine, 10%. 19 But in our study, only 1 patient in group I had pruritis while there were no cases in Group II. None of the patients in both the Groups had any episodes of respiratory distress.…”

Section: Discussioncontrasting

confidence: 61%

Comparative study of intrathecal bupivacaine 0.5% with bupivacaine 0.5% and buprenorphine low dose for postoperative analgesia in lower abdominal surgeries

Rao¹,

Prakash²

2016

Int Surg J

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INTRODUCTIONPain is one of the most common and uncomfortable consequences of a surgery, feared by all. Effective and rapid relief from pain is always a challenge, but is necessary for alleviating nocioception -induced responses like endocrine metabolic responses to surgery, autonomic reflexes with adverse effects on organ function, reflexes leading to muscle spasm, and other undesirable results. 1 ABSTRACT Background: Opiods, like buprenorphine, have been widely used for providing pain relief postoperatively and their advantages of neuraxial narcotics over systemic narcotics are well established. When compared to local anaesthetics, they offer good analgesia while allowing early ambulation of the patient by sparing sympathetic and motor nerves. This study was conducted to compare the efficacy of bupivacaine alone and in combination with low dosage of buprenorphine. Methods: 80 patients between the ages 20-60 undergoing lower abdominal surgeries were divided into 2 groups of 40 each after taking detailed history and undergoing the necessary preliminary tests. Patients in the Group I was given 17.5mg of 0.5% Hyperbaric Bupivacaine along with 60ug of Buprenorphine. The patients in Group II received 17.5mg of 0.5% Hyperbaric Bupivacaine. Onset and duration of analgesia were recorded. The efficacy of analgesia was recorded based on VAS score. Side effects, time of recovery also were noted. Results: In this retrospective study we found that incidence of colorectal carcinoma is more between 40-60 years of age with male predominance; lymph node metastasis is more than metastasis in any other sites. CT scan can diagnose lymphatic metastasis and infiltration in surrounding tissue more accurately. Percentage of sphincter saving procedure was low in rectal malignancies in our study. Conclusions: The onset of analgesia was within 5 minutes in 100% of the cases in Group I while in Group II it was upto 9 minutes. The mean of the duration of analgesia was 15h 33mins and 3 h 18 mins in Group I and II respectively. The pain scoring through VAS in the 2 groups showed that most of the patients in Group I had 0 to mild pain till about 12 hours while in Group II the analgesic effect was felt only till the first 2 hours. The supplementary analgesic was required on Group II within 4 hours post operatively while in Group I the requirement was only after 12 hours. The major side effect among the patients was vomiting and nausea in 12 patients in Group I followed by urinary retention in 6 patients. While in Group II only 6 patients had nausea and no other side effect. Pruritis was observed in 1 patient in Group I Respiratory distress, drowsiness, headache and backache was not observed in any of the cases.

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Section: Discussioncontrasting

confidence: 61%

Comparative study of intrathecal bupivacaine 0.5% with bupivacaine 0.5% and buprenorphine low dose for postoperative analgesia in lower abdominal surgeries

Rao¹,

Prakash²

2016

Int Surg J

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“…Using previous results for morphine and fentanyl (the two most commonly studied opioids) the power of the current study was calculated as 0.8 for nausea and vomiting and 0.7 for pruritis (a ¼ 0.05) [5,6,[9][10][11][12][13]. Previous results for morphine and methadone gave the power of the current study for urinary retention as > 0.95 (a ¼ 0.05) [12,14,15].…”

Section: Discussionmentioning

confidence: 99%

Side‐effects of epidural infusions of opioid bupivacaine mixtures

Gedney

Liu

1998

Anaesthesia

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SummaryThe incidence of side-effects occurring with epidural diamorphine (0.05 mg.ml ¹1 ), fentanyl (2.0 mg.ml ¹1 ), methadone (0.1 mg.ml ¹1 ), morphine (0.05 mg.ml ¹1 ) and pethidine (1.0 mg.ml ¹1 ) used by infusion in combination with bupivacaine has been compared. One hundred and sixty patients were studied, 32 receiving each opioid. The incidence of nausea and vomiting was significantly greater with morphine than fentanyl (p ¼ 0.0097) and pethidine (p ¼ 0.0021). The incidence of pruritis was significantly greater with morphine and diamorphine than with methadone (p ¼ 0.012) and pethidine (p ¼ 0.027). Morphine was also associated with a significantly greater incidence of urinary retention than pethidine (p ¼ 0.012) and methadone (p ¼ 0.025).

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“…Palacious et al and Ackerman et al reported incidence of pruritus to be 1.4% and 6.7% respectively but none of the patients in our study developed this complication. 7,8 Bharati et al and Parikh et al also did not demonstrate pruritus in any of their patients. 9,10 Respiratory depression was not seen in any patient in the presence cohort.…”

Section: Discussionmentioning

confidence: 71%

A comparative study between epidural butorphanol with bupivacaine and bupivacaine alone for intra-operative and post-operative analgesia in lower limb orthopaedic surgeries

Kar

2016

Int J Res Med Sci

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A comparison of the incidence of pruritus following epidural opioid administration in the parturient

Cited by 53 publications

References 12 publications

Comparative study of intrathecal bupivacaine 0.5% with bupivacaine 0.5% and buprenorphine low dose for postoperative analgesia in lower abdominal surgeries

Comparative study of intrathecal bupivacaine 0.5% with bupivacaine 0.5% and buprenorphine low dose for postoperative analgesia in lower abdominal surgeries

Side‐effects of epidural infusions of opioid bupivacaine mixtures

A comparative study between epidural butorphanol with bupivacaine and bupivacaine alone for intra-operative and post-operative analgesia in lower limb orthopaedic surgeries

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