Study of Intrathecal Buprenorphine for Postoperative Analgesia after Cesarean section

Jejani, Ayushma; Chaudhari, Ashok; Singam, Amol

doi:10.5958/0974-360x.2019.01052.7

Cited by 5 publications

(3 citation statements)

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“…Similar findings were observed for vomiting, with 12% of patients in Group A experiencing vomiting compared to 4% in Group B. These results highlight the potential antiemetic properties of buprenorphine, which is consistent with the studies conducted by Ravindran et al 11 and Jejani et al 16 Comparing our findings with the mentioned studies, Arora et al 14 and Haribabu et al 15 reported similar results regarding the reduction in hypotension incidence with the addition of buprenorphine. Ravindran et al 11 and Deshmukh et al 12 demonstrated prolonged analgesic duration with buprenorphine-bupivacaine combination, supporting our findings.…”

Section: Discussionsupporting

confidence: 91%

Comparative study on analgesia duration with bupivacaine-buprenorphine combination vs. bupivacaine alone for cesarean delivery

Memon,

Malik,

Memon

et al. 2023

Anaesth. pain intensive care

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BACKGROUND: Spinal anesthesia has been the preferred type of anesthesia for cesarean sections and other obstetric operations. Bupivacaine has been used for this purpose being long acting. Lately various narcotic analgesics have been added to prolong the analgesia and reduce the expected toxicity of bupivacaine alone. We evaluated the duration of analgesia achieved with the combination of bupivacaine-buprenorphine versus bupivacaine alone in cesarean delivery under spinal anesthesia. Methods: A comparative study was conducted at a tertiary care teaching healthcare center in Karachi, Pakistan. One hundred patients scheduled for elective cesarean section were enrolled and divided into two groups. Group A received 10 mg of hyperbaric bupivacaine 0.5% along with normal saline, while Group B received the same dose of bupivacaine along with buprenorphine 75 µg. Preoperative assessment, intraoperative procedures, and postoperative management were performed following standard protocols of our institution. Statistical analysis was conducted using independent t-tests and chi-square tests. Results: The findings revealed significantly longer mean time to request for analgesia in Group B compared to Group A (825.33 min vs. 166.78 min; P = 0.182), Only 14 patients in Group B (28%) required analgesia within 24 h, while all patients in Group A requested analgesia within that time frame (P = 0.0001). Moreover, an insignificantly lower incidence of hypotension and reduced need for phenylephrine administration was observed in Group B compared to Group A (P = 0.585). Group B also demonstrated a lower incidence of nausea (P = 0.380) and vomiting (P = 0.370) compared to Group A, but the difference was statistically not significant. Conclusion: This study suggests that the addition of buprenorphine to bupivacaine in spinal anesthesia for cesarean delivery provides prolonged analgesia, reduces the incidence of nausea and vomiting, and decreases the need for vasopressor administration. These findings support the potential benefits of using the bupivacaine-buprenorphine combination in cesarean deliveries. Key words: Cesarean Delivery; Opioids, Intrathecal; Anesthesia, Spinal; Bupivacaine; Buprenorphine; Analgesia, Duration Citation: Saleh M, Malik S, Memon GN, Rehman M. Comparative study on analgesia duration with bupivacaine-buprenorphine combination vs. bupivacaine alone for cesarean delivery. Anaesth. pain intensive care 2023;27(5):501−505; DOI: 10.35975/apic.v27i5.2303 Received: July 29, 2023; Reviewed: August 10, 2023; Accepted: August 10, 2023

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Section: Discussionsupporting

confidence: 91%

Comparative study on analgesia duration with bupivacaine-buprenorphine combination vs. bupivacaine alone for cesarean delivery

Memon,

Malik,

Memon

et al. 2023

Anaesth. pain intensive care

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“…They concluded that intrathecal low dose analgesia with heavy Bupivacaine + fentanyl + morphine can be used effectively in both primi & multi parturients with no increase in risk of C-section among patients. Few more studies on similar aspects were reviewed [12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Intrathecal Dexmedetomidine and Fentanyl as Adjuvant to Bupivacaine for Labour Analgesia: A Study Protocol

Sharma

Chandak

2021

JPRI

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Background: The most commonly used labour analgesia is epidural. Another alternative method is intrathecal low dose analgesic, given for providing labour analgesia in the areas where the epidural kit, multiparameter monitors, staff members scarcity is present. Fentanyl has been used widely to decrease motor block effect of local anaesthetics during labour, presence of these opioids along with local anaesthetics can cause pruritus and respiratory depression. Selective α2- agonist Dexmedetomidine (DMT) helps in providing stable haemodynamic parameters, and an effective intraoperative and postoperative analgesia. This study aims to compare the effectiveness of an intrathecal analgesia during labor, using bupivacaine in combination with dexmedetomidine and fentanyl in terms of quality and duration of analgesia. Materials and Methods: This will be a prospective comparative observational study. Total 80 patients will be included in the study and assigned to two groups by computerized randomization method. GROUP BD (n=40) will receive an intrathecal 0.5% hyperbaric bupivacaine dose 2.5 mg along with dexmedetomidine dose 2.5 μg .GROUP BF (n=40) will receive an intrathecal 0.5% hyperbaric bupivacaine 2.5mg with fentanyl 25mcg. Data will be analysed and Quality and duration of analgesia will be compared for both groups. Expected Results: Significant difference is expected in labor analgesia and safety profile with the combination of intrathecal bupivacaine and dexmedetomidine compared to combination of bupivacaine and fentanyl.

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“…Traditionally, opioids or NSAID'S in various combinations have been used for post operative analgesia after laparoscopic procedures 4,5,6 . Intraperitoneal instillation of local anesthetic agents alone or in combination of opioids 2,3 , alpha-2 agonists dexmedetomidine and clonidine have been found to reduce post operative pain following laparoscopic cholecystectomy 7,8 . Pain due to laparoscopic surgeries is because of, stretching and peritoneal inflammation.…”

Section: Introductionmentioning

confidence: 99%

A Prospective Comparative Study to Assess-Post Operative Analgesic Effect of Intraperitoneal Instillation of Bupivacaine with Dexmedetomidine to Bupivacaine with Tramadol in Patients Undergoing Laparoscopic Cholecystectomy

2020

IJFMT

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Objective: Tocompare post operativeanalgesic effect of intraperitoneal instillation of bupivacaine with dexmedetomidine, to bupivacaine with tramadol in patients undergoing laparoscopic cholecystectomy.Method: Sixty patients belonging to age group 20 to 50 years, from both sexes posted for laparoscopic cholecystectomy under general anesthesia were enrolled in our study. They were randomized in two groups, Group A and Group B with 30 patients each. ASA1 & ASA2 physical status were selected. A written and informed consent was taken from all the patients. The group A received 35 ml of 0.25% Bupivacaine with 50 mcgdexmedetomidine and Group B received 35 ml of 0.25% bupivacaine with 50 mg tramadol before removal of trocar. The sites selected for instillation were hepato-diaphragmatic space (10ml), sub hepatic (10ml), on gall bladder bed (10ml) and near and above hepatoduodenal ligament (5ml), at the end of surgery. Intraoperative hemodynamic monitoring was done. Postoperative pain relief was assessed hourly for first 6 hours by VASscore. Time to requirement of first dose of rescue analgesia was noted and this was the endpoint of this study, although the patients were monitored for 24 hours. Sideeffects like postoperative nausea, vomiting and respiratory depression were noted. Results:We noted that intraperitoneal instillation of bupivacaine with dexmedetomidine prolonged the duration of post operative analgesia compared to bupivacaine & tramadol combination. The requirement of first dose of rescue analgesic is delayed more inbupivacaine dexmedetomidine group as compared to bupivacaine tramadol group. Also the incidence of post operative nausea and vomiting was found to be less in group Ai.e. bupivacaine dexmedetomidine group. Conclusion:From this study it can be concluded that the use of intraperitoneal instillation of bupivacaine with dexmedetomidine significantly reduces the requirement of post operative analgesics in patients undergoing laparoscopic cholecystectomy with better compliance.

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Study of Intrathecal Buprenorphine for Postoperative Analgesia after Cesarean section

Cited by 5 publications

References 0 publications

Comparative study on analgesia duration with bupivacaine-buprenorphine combination vs. bupivacaine alone for cesarean delivery

Comparative study on analgesia duration with bupivacaine-buprenorphine combination vs. bupivacaine alone for cesarean delivery

Effectiveness of Intrathecal Dexmedetomidine and Fentanyl as Adjuvant to Bupivacaine for Labour Analgesia: A Study Protocol

A Prospective Comparative Study to Assess-Post Operative Analgesic Effect of Intraperitoneal Instillation of Bupivacaine with Dexmedetomidine to Bupivacaine with Tramadol in Patients Undergoing Laparoscopic Cholecystectomy

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