Comparative effects of buprenorphine and dexmedetomidine as adjuvants to bupivacaine spinal anaesthesia in elderly male patients undergoing transurethral resection of prostrate: A randomized prospective study

Kaur, Navdeep; Umesh, Goneppanavar; Ramesh, Venkateswaran; Iyer, Sadasivan S

doi:10.4103/aer.aer_163_17

Cited by 13 publications

(4 citation statements)

References 22 publications

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“…The mean duration of motor block in both buprenorphine and magnesium groups were significantly longer when compared to control group. This observation in relation to the adjuvant groups and control group is supported by studies done by Hemalatha et al, Kaur et al, Shukla et al, (14,17,18) These findings can be attributed to buprenorphine's nonspecific local anesthetic effect (19) and magnesium ions' ability interfere with normal electrophysiological properties of nerve fibres (15,20) resulting in more pronounced motor blockade than plain bupivacaine.…”

Section: Discussionsupporting

confidence: 65%

Buprenorphine Versus Magnesium Sulphate: Adjuvants to Intrathecal Hyperbaric Bupivacaine for Lower Abdominal Surgeries

Bafna,

Ponnusamy

2021

IJMBS

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Aims: An adjuvant to a local anaesthetic can potentiate spinal anesthesia and provide better postoperative analgesia. Our study has been drafted to evaluate and compare the analgesic potency of the adjuvants, buprenorphine and magnesium, to intrathecal 0.5% hyperbaric bupivacaine. Methods: One hundred and fifty patients by inclusion criteria posted for an elective lower abdominal surgery were randomised into three groups of 50 each. They received 3ml of 0.5% hyperbaric bupivacaine with either 1ml of 0.9% Saline or 1ml of buprenorphine (60?g) or 1ml of magnesium sulphate (50mg). Time for first rescue analgesia, onset of sensory and motor blocks, time to two-segment regression and duration of motor block, haemodynamic parameters, and side effects were studied. Data was analyzed with ANOVA, Kruskal-Wallis H, Chi-square and Fischer’s exact tests. Our Study was carried out from January 2020 to April 2020. Results: The time for first analgesic request was 248.70> 186.84> 141.44 minutes (Buprenorphine> magnesium> control), p<0.001. The onset of sensory and motor blocks was faster in buprenorphine group compared to magnesium and control groups. The time to two-segment regression and duration of motor block was significantly prolonged in buprenorphine and magnesium groups compared to control group. Conclusion: The time to first analgesic request was longer with buprenorphine compared to magnesium sulphate with adequate sedation and negligible complications. Hence, addition of adjuvant buprenorphine (60?g) has a better demonstrable role in postoperative analgesia compared to adjuvant magnesium (50mg) or 0.5% hyperbaric bupivacaine alone. Keywords: Spinal Anaesthesia; Intrathecal buprenorphine; Intrathecal magnesium; Analgesic efficacy; Intrathecal adjuvants

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Section: Discussionsupporting

confidence: 65%

Buprenorphine Versus Magnesium Sulphate: Adjuvants to Intrathecal Hyperbaric Bupivacaine for Lower Abdominal Surgeries

Bafna,

Ponnusamy

2021

IJMBS

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“…These results are in contradiction to our study, duration of postop analgesia was prolonged to 589 ± 158.3 min. 16 In our study VAS never rose above 2.95 and 2.20 in Group B and T respectively as 14 (25%) patients in Group B and 22 patients (40%) in Group T did not complain of pain and didn't receive any rescue analgesic, and there VAS did not rose above 2 in postoperative period. Because of those patients the overall VAS score of both groups is reduced, as VAS is calculated as mean of all patients of both groups.…”

Section: Discussioncontrasting

confidence: 39%

A comparative study of the effect of intrathecal tramadol and buprenorphine used as adjuvants to hyperbaric bupivacaine for postoperative analgesia in infraumbilical surgeries

Siddiq

Asad

Rehman

et al. 2019

APIC

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Background & Objective: The augmentation of local anesthetics with various adjuvants to enhance the quality and efficacy of subarachnoid block is clinically in practice since long. Comparative studies on effects of adding intrathecal tramadol and buprenorphine has never been studied before. Both drygs are esily available in our country. So, we conducted this study to evaluate and compare the characteristics of subarachnoid blockade, duration of postoperative analgesia, dose of recue analgesic postoperatively, and adverse effects of intrathecal buprenorphine (50 μg) and intrathecal tramadol (30 mg) as adjuvants to 0.5% hyperbaric bupivacaine for lower abdominal surgeries Methodology: This prospective randomized, single blind controlled trial was carried out at Services Hospital Lahore, from January to July 2018. 110 American society of Anesthesiologist I - II male patients, 35 to 45 y of age undergoing subarachnoid block for infra-umbilical surgery were randomized into two groups. Group T (n = 55) patients received 10 mg of 0.5% bupivacaine and 30 mg of tramadol intrathecally, while group B (n = 55) received 10 mg 0.5% bupivacaine with 50 μg of buprenorphine. Sensory testing was done by pin prick method using 25G blunt needle and time taken to reach T10 level noted. Motor block was assessed using Modified Bromage Scale. The time taken to reach modified Bromage 3 was recorded. Side effects and postoperative analgesia noted for 24 h by VAS score every 20 min for first 2 h in PACU and then 4 hourly for 24 h in the ward. Patients with inadequate block were converted into general anesthesia and were excluded from the study. Time to first rescue analgesia, and total analgesic required in 24 h were compared in two groups.Results: Mean VAS scores were less in Group T as compared to Group B. Significant difference was seen among groups at 45 min (p = 0.04), 60 min (p = 0.02), 75 min (p = 0.03), 90 min (p = 0.01), 120 min (p = 0.00), 4h (p = 0.007), 8 h (p = 0.01), 12 h (p = 0.01), 16 h (p = 0.00). After 24 h no significant difference was seen in both groups. Mean onset time for sensory block was earlier in Group B (2.4 min) compared to Group T (2.7 min)(p = 0.001). Mean onset time for motor block was earlier in Group B (4.8 min)as compared to Group T (5.5 min)(p = 0.00). No significant difference was seen among groups in side effects (p > 0.05). Mean time for rescue analgesia in Group B was earlier (4.51 ± 2.8 h.) as compared to Group T (4.94 ± 4.1h). Total dose of analgesic given in 24 h was significantly less in group T. (p = 0.004) The mean dose given in Group B (1.24 ± 0.96 mg/kg) was greater than Group T (0.76 ± 0.71 mg/kg)Conclusion: We conclude that both tramadol and buprenorphine, prolong the duration of postop analgesia without adding any adverse effects, but duration with tramadol is longer; it significantly reduces VAS and the dose of analgesic requirement in 24 h postoperatively.IRB letter No. IRB/2018/427/SIMS Citation: Siddiq S, Asad N, Rehman AU, Ali M, Khalid HMU, Butt Z. A comparative study of the effect of intrathecal tramadol and buprenorphine used as adjuvants to hyperbaric bupivacaine for postoperative analgesia in infraumbilical surgeries. Anesth pain & intensiv care 2019;23(3):263-267

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“…They came up with the findings that adding buprenorphine (60 μg) or dexmedetomidine (5 μg) to routine bupivacaine dose used for spinal anaesthesia reduce the need for early postoperative analgesia. 10 We compared low dose ropivacaine plus dexmedetomidine with bupivacaine. Requirement for opiate analgesia was not different in both groups but other efficacy parameters were better in combination group.…”

Section: Discussionmentioning

confidence: 99%

Comparison of low dose ropivacaine plus dexmedetomidine vs. low dose bupivacaine for spinal anesthesia in transurethral resection of prostate

Hassan,

Zafar,

Ameer

et al. 2023

Anaesth. pain intensive care

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Background & Objective: Spinal anesthesia (SA) has been preferred for transurethral resection of prostate (TURP) due to various advantages over general anesthesia. The most commonly used drug for SA is bupivacaine, but recently ropivacaine has been introduced with better hemodynamic profile. Dexmedetomidine is sedative-analgesic, and can be used through multiple routes. We compared low dose ropivacaine plus dexmedetomidine vs. low dose bupivacaine for SA in TURP. Methodology: This comparative, cross-sectional study was conducted at Anesthesia Department of Combined Military Hospital, Lahore, from December 2021 to June 2022. A total of 197 patients, planned to undergo TURP under SA were included in the study. The patients were randomly allotted to one of the two groups by lottery method and using concealed envelops. Group RD took low dose ropivacaine (7.5 to 10 mg) plus dexmedetomidine (5 µg) and in Group B low dose bupivacaine (7.5 to 10 mg) was used for spinal anesthesia. Parameters of efficacy and safety were compared in both groups during and immediately after the surgery to look for better option among the two regimes. Results: Out of 197 patients randomized into two groups, Group RD, 99 (50.2%) took low dose ropivacaine (7.5 to 10 mg) plus dexmedetomidine (5 µg) and 98 (49.8%) took low dose bupivacaine (7.5 to 10 mg) for spinal anesthesia. Mean age of patients who underwent TURP in our study was 61.66 ± 7.88 y. Hemodynamic instability and requirement of opiate analgesia was not significantly different in both the groups (P > 0.05) while all other efficacy parameters were better in patients who took low dose ropivacaine plus dexmedetomidine (P < 0.05) as compared to those who only took low dose bupivacaine. Conclusion: Both groups showed no difference in safety parameters related to hemodynamic stability but the anesthesia profile was better in patients who took low dose ropivacaine plus dexmedetomidine as compared to the bupivacaine group. Abbreviations: SA - Spinal anesthesia; TURP - Transurethral resection of prostate Key words: Bupivacaine; Dexmedetomidine; Ropivacaine; Anesthesia, Spinal; Transurethral Resection of Prostate Citation: Ul Hassan J, Zafar E, Akram M, Saleem MA, Sami A. Comparison of low dose ropivacaine plus dexmedetomidine vs. bupivacaine for spinal anesthesia in transurethral resection of prostate. Anaesth. pain intensive care 2023;27(5):535−538; DOI: 10.35975/apic.v27i5.2309

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Comparative effects of buprenorphine and dexmedetomidine as adjuvants to bupivacaine spinal anaesthesia in elderly male patients undergoing transurethral resection of prostrate: A randomized prospective study

Cited by 13 publications

References 22 publications

Buprenorphine Versus Magnesium Sulphate: Adjuvants to Intrathecal Hyperbaric Bupivacaine for Lower Abdominal Surgeries

Buprenorphine Versus Magnesium Sulphate: Adjuvants to Intrathecal Hyperbaric Bupivacaine for Lower Abdominal Surgeries

A comparative study of the effect of intrathecal tramadol and buprenorphine used as adjuvants to hyperbaric bupivacaine for postoperative analgesia in infraumbilical surgeries

Comparison of low dose ropivacaine plus dexmedetomidine vs. low dose bupivacaine for spinal anesthesia in transurethral resection of prostate

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