Effect of Fentanyl in Spinal Anesthesia With Bupivacaine in Opium Abusers

Zirak, Nahid; Soltani, Ghasem; Javdani, Nahid; Shamloo, Alireza Sepehri; Bameshki, Alireza; Peyvandi, Arash

doi:10.5812/rijm.14271

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…The onset of sensory block and regression of motor block to zero was faster in group BF (p <0.05).. TAR was also prolonged in BF group (233.41±46.46 min) than in group B (213.19±51.46 min), and it is statistically signi cant (p<0.05).This result is in accordant with prospective comparative study done in India [14], showed earlier onset of sensory analgesia, time to achieve peak sensory level, and recovery from motor blockade in group BF than in group B. This is also in line with another study conducted in Iran [17][22], showed the mean duration of sensory block was much longer in group BF than in group B but time to achieve maximum level of block and Mean time of two-segment regression was much shorter in group BF than in group B.…”

supporting

confidence: 89%

Effect of low dose Bupivacaine with Fentanyl on hemodynamic response: A Prospective cohort study

Obsa¹,

Negash²,

Kassa³

et al. 2020

Preprint

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Background: A conventional dose of local anesthetics is used during spinal anesthesia. However an unwanted hemodynamic effect by administration of adjuvants with low dose of local anesthetics has been observed. The purpose of the study was to compare the effect of low dose Bupivacaine with Fentanyl versus normal dose Bupivacaine alone on hemodynamic response in elderly patients. Methods: A Prospective cohort study was employed on a total of 64 elderly patients undergoing lower extremity orthopedics surgery. An exposed group (group BF) received 10mg of 0.5% isobaric bupivacaine with 25mcg of fentanyl and a non-exposed group (Group B) received 15 mg of 0.5% isobaric bupivacaine alone. Systematic random sampling technique was used to select study participants. Parametric data was analyzed by using independent t-test, nonparametric data by using Mann-Whitney U-test and homogenous categorical data by using chi-square test and fisher exact test. The level of statistical significance for all tests was found to be P < 0.05. Results: The incidence of hypotension was higher in group B than group BF (37.5% vs. 9.4%, respectively) and statistically significant differences was observed (p=0.008). The onset of sensory block and regression of motor block to zero were faster in group BF than in group B (p <0.05). TAR was also prolonged in group BF (P<0.05). Conclusion: Low dose Bupivacaine with Fentanyl has lower incidence of hypotension, fast onset of sensory block and prolonged first analgesia request time than bupivacaine alone Therefore, we recommends the use of low dose bupivacaine with fentanyl to have a better hemodynamic stability than conventional dose of bupivacaine for elderly patients who undergoes lower extremity surgery.

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supporting

confidence: 89%

Effect of low dose Bupivacaine with Fentanyl on hemodynamic response: A Prospective cohort study

Obsa¹,

Negash²,

Kassa³

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…In another study conducted by the same team, the effect of intrathecally administration of lidocaine in spinal anesthesia was studied in chronic opioid users with similar outcomes, including shorter sensory and motor blockade during spinal anesthesia in chronic opium abusers ( 8 ). To lengthen this shortened duration in chronic opium abusers, fentanyl, midazolam and ketamine have been proposed as an adjuvant ( 9 - 12 ).…”

Section: Discussionmentioning

confidence: 99%

The Effect of Adding Sufentanil to 0.5% Hyperbaric Bupivacaine on Duration of Brachial Plexus Blockade in Chronic Opium Abusers: a Randomized Clinical Trial

et al. 2015

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Background:Anesthesia induction in patients with current substance abuse can be a challenge for anesthesiologists.Objectives:This study aimed to evaluate the effect of adding Sufentanil to Bupivacaine on duration of brachial plexus nerve block.Patients and Methods:One hundred and twenty patients with (Groups C and D) and without (Groups A and B) a history of opium abuse (60 in each group) scheduled for elective upper extremity procedures were randomly assigned to either receive 30 mL bupivacaine alone (Groups A and C) or in combination with additional 10 µg sufentanil (Groups B and D). An ultrasound-guided technique was applied to perform upper extremity brachial plexus blockade. The onset and duration of sensory and motor blocks were recorded and compared between the four groups.Results:The duration of sensory and motor block were significantly less in Group C (537.0 ± 40.1 minutes, 479.0 ± 34.8 minutes) and the longest duration of sensory and motor block was observed in group B (705.0 ± 43.8 minutes, 640.0 ± 32.5 minutes). The duration of sensory and motor block in Group B (705.0 ± 43.8 minutes, 640.0 ± 32.5 minutes) was longer and statistically higher than group A (619.5 ± 48.0 minutes, 573.2 ± 31.5 minutes), the same trend was observed in group D (598.6 ± 53.2 minutes, 569.3 ± 39.9 minutes) over group C (537.0 ± 40.1 minutes, 479.0 ± 34.8 minutes) (P < 0.001, one-way ANOVA).Conclusions:The length of sensory and motor blockade is shorter in chronic opioid abusers. Adding 10 µg sufentanil to hyperbaric bupivacaine in opium abusers lengthened the sensory and motor block duration.

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Comparison of low-dose ketamine to methadone for postoperative pain in opioid addicts: a randomized clinical trial

Bakhtiari,

Dori,

Razavi

et al. 2024

Anesth Pain Med

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Background: Postoperative pain can lead to several complications. The effectiveness of different opioids in relieving pain after surgery has been widely studied. However, managing pain in patients with opioid addiction is still challenging. This study aimed to examine the impact of ketamine and methadone on postoperative pain in patients with addiction.Methods: This was a non-inferiority randomized clinical trial. All included patients were monitored for morphine use, pain scores, and vital signs every 3 h. The intervention group received 0.5 mg/kg ketamine administered intravenously every 6 h. The control group received 5 mg of methadone intramuscularly every 8 h. The patient received intravenous morphine if their visual analog scale was above 3. All side effects in each group were recorded.Results: Two hundred and twenty patients were included in this study. There were 127 men (57.7%) with an average age of 57.1 ± 19.5 and 93 women (42.3%) with an average age of 57.1 ± 21.0. There were no significant differences in demographic characteristics between the groups. There was no significant difference in the dose or frequency of morphine administration between groups. There was no significant difference between the groups in pain scores and vital signs at different time points. Drug side effects, including delirium and gastrointestinal symptoms, did not differ significantly between the methadone and ketamine groups. Conclusions: Our clinical data support the hypothesis that ketamine is not inferior to methadone in patients with addiction. Future randomize clinical trials are needed to confirm these observations.

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Effect of Fentanyl in Spinal Anesthesia With Bupivacaine in Opium Abusers

Cited by 3 publications

References 17 publications

Effect of low dose Bupivacaine with Fentanyl on hemodynamic response: A Prospective cohort study

Effect of low dose Bupivacaine with Fentanyl on hemodynamic response: A Prospective cohort study

The Effect of Adding Sufentanil to 0.5% Hyperbaric Bupivacaine on Duration of Brachial Plexus Blockade in Chronic Opium Abusers: a Randomized Clinical Trial

Comparison of low-dose ketamine to methadone for postoperative pain in opioid addicts: a randomized clinical trial

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