Online ISSN: 2515-8260

Keywords : sensory blockade


A CLINICAL STUDY COMPARING EFFICACY OF EPIDURAL PLAIN BUPIVACAINE AND BUPIVACAINE PLUS FENTANYL IN ABDOMINAL AND LOWERLIMB SURGERIES

Dr . P. Sravani, Dr. Sathish Bobba ,Dr . Sairaj V

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5943-5951

Introduction: Epidural anesthesia is a type of neuraxial anesthesia; used for anesthesia of
abdominal, pelvic, and lower extremity procedures and, less commonly, thoracic procedures
and as a supplement to general anesthesia for thoracic, abdominal, and pelvic procedures and
for postoperative analgesia following aforementioned procedures.
Aims: A clinical study comparing efficacy of epidural plain Bupivacaine and combination of
Bupivacaine plus Fentanyl in abdominal and lower limb surgeries.
Materials and Methods: The present clinical study has been carried during 2017-2019,The
Study was under taken to compare the efficacy of Bupivacaine and combination of
Bupivacaine with fentanyl regarding onset, duration and quality of analgesia when given
extraduraly.The study was conducted on 100 adult patients of ASA grade Ι and ΙΙ.
Results: The time of onset of analgesia was determined by pin prick method every one
minute till there was absence of pain sensation and maximum sensory blockade. The quality
of analgesia was recorded as excellent, good, fair and poor. Duration of analgesia was
deduced by testing every 15 minutes with pinprick method for return of sensation in two
dermatomes below the highest level of block achieved i.e., 2-segment regression. The
complications were noted.
Conclusion: The onset of analgesia was quick and time for complete analgesia was earlier in
Bupivacaine and Fentanyl combination group when compared to Bupivacainegroup.The
quality of analgesia was excellent in Bupivacaine and Fentanyl group when compared to
Bupivacainegroup.

A CLINICAL STUDY COMPARING EFFICACY OF EPIDURAL PLAIN BUPIVACAINE AND BUPIVACAINE PLUS FENTANYL IN ABDOMINAL AND LOWERLIMB SURGERIES.

Dr . P. Sravani, Dr. Sathish Bobba, Dr . Sairaj V .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10707-10714

Introduction: Epidural anesthesia is a type of neuraxial anesthesia; used for anesthesia of abdominal, pelvic, and lower extremity procedures and, less commonly, thoracic procedures and as a supplement to general anesthesia for thoracic, abdominal, and pelvic procedures and for postoperative analgesia following aforementioned procedures.
Aims: A clinical study comparing efficacy of epidural plain Bupivacaine and combination of Bupivacaine plus Fentanyl in abdominal and lower limb surgeries.
Materials and Methods: The present clinical study has been carried during 2017-2019,The Study was under taken to compare the efficacy of Bupivacaine and combination of Bupivacaine with fentanyl regarding onset, duration and quality of analgesia when given extraduraly.The study was conducted on 100 adult patients of ASA grade Ι and ΙΙ.
Results: The time of onset of analgesia was determined by pin prick method every one minute till there was absence of pain sensation and maximum sensory blockade. The quality of analgesia was recorded as excellent, good, fair and poor. Duration of analgesia was deduced by testing every 15 minutes with pinprick method for return of sensation in two dermatomes below the highest level of block achieved i.e., 2-segment regression. The complications were noted.
Conclusion: The onset of analgesia was quick and time for complete analgesia was earlier in Bupivacaine and Fentanyl combination group when compared to Bupivacainegroup.The quality of analgesia was excellent in Bupivacaine and Fentanyl group when compared to Bupivacainegroup.

Comparative study between intrathecal bupivacaine 0.5% heavy + fentanyl (0.5 microgram/Kg) versus intrathecal bupivacaine 0.5% heavy + buprenorphine (2 microgram/Kg) in lower abdominal and lower limb surgeries

Dr. Siddhartha Rapolu, Dr. Prathap Sidda

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2456-2462

Aim: To evaluate the efficacy of the combination of intrathecal bupivacaine 0.5% heavy + fentanyl (0.5 microgram/kg) versus intrathecal bupivacaine 0.5% heavy + buprenorphine (2 microgram/kg) in lower abdominal and lower limb surgeries.
Materials and Methods: A total of 80 patients who underwent lower abdominal and lower limb surgeries were taken up for the study. Patients were randomised into two groups each. Patients allotted with odd numbers were in GROUP F: Bupivacaine +Fentanyl group (n=40) and patients allotted with even numbers were in GROUP B: Bupivacaine + Buprenorphine group (n=40). Group F received 3ml, 0.5% hyperbaric bupivacaine + Fentanyl (0.5mcg/Kg), Group B received 3ml, 0.5% hyperbaric bupivacaine + Buprenorphine (2mcg/Kg).
Results: In the current study, onset of analgesia was significantly earlier due to the addition of buprenorphine. This may be attributed to high lipid solubility and highest affinity for opiate receptors of buprenorphine. Both the groups had the same mean time to achieve motor blockade. Both groups maintained hemodynamic stability which was statistically insignificant. The mean duration of effective analgesia in Group A and group B found significant statistically (p<0.01).
Conclusion: We observed that anaesthesia was superior when buprenorphine is mixed with bupivacaine (0.5%) as compared to bupivacaine with fentanyl. Addition of buprenorphine to bupivacaine 0.5% augments the sensory blockade of local anaesthetics without affecting the sympathetic activity. Thus, it is concluded that intrathecal buprenorphine is suitable drug for post-operative analgesia for caesarean section.

Assessment of effectiveness of bupivacaine versus levobupivacaine in supraclavicular brachial plexus block

Kaushikkumar.D.Prajapati, Dinesh Meghjibhai Chaudhary, Nikulbhai Jivanbhai Prajapati

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 671-675

Background:Brachial plexus block is a regional technique commonly employed for upper limb
surgeries. The present study was conducted to assess effectiveness of bupivacaine versus
levobupivacaine in supraclavicular brachial plexus block.
Materials & Methods:70 patients of ASA I & II status were given brachial plexus block by
supraclavicular approach for various upper limb surgeries of both genders. Group I patients
received bupivacaine and group B received levobupivacaine. Onset and duration of sensory
and motor block was recorded. Duration of analgesia was considered as the time taken to
reach an NRS score of 3.
Results: ASA grade I was seen in 25 in group I and 18 in group II and II in 10 in group I and
17 in group II. The mean age was 35.4 years in group I and 35.1 years in group II and weight
was 61.2 Kgs in group I and 62.7 Kgs in group II. The mean onset of sensory block was 12.8
minutes in group I and 10.1 minutes in group II, onset of motor block was 14.9 minutes in
group I and 11.3 minutes in group II, duration of sensory block (minutes) was 812.8 minutes
in group I and 1024.6 minutes in group II, duration of motor block (minutes) was 926.2
minutes in group I and 1156.4 minutes in group II and duration of analgesia (minutes) was
910.2 minutes in group I and 1058.0 minutes in group II. The difference was significant (P<
0.05).
Conclusion: Levobupivacaine has a faster onset of both sensory and motor blockade as
compared to bupivacaine.