Online ISSN: 2515-8260

Keywords : intrathecal buprenorphine


A comparative study of intrathecal bupivacaine 0.5% heavy with fentanyl versus intrathecal bupivacaine 0.5% heavy with buprenorphine in lower limb and lower abdominal surgeries

Dr. Mrunalini Alugolu, Dr.Padmavathi Bodiga, Dr. Pratiksha Chitta, Dr Praveena Thaduri

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2342-2352

Aims: The aim of the study is to compare the anaesthetic efficacy of intrathecal
hyperbaric 0.5% Bupivacaine with 25mcg Fentanyl and intrathecal hyperbaric 0.5%
Bupivacaine with 60mcg Buprenorphine for lower abdominal and lower limb surgeries
Materials and methods: The present study was undertaken in Sixty patients (of either
sex belonging to ASA I and II physical status) posted for elective lower abdominal and
lower limb surgeries (under Spinal Anesthesia) were selected and were randomly
allocated into two groups; Buprenorphine (Group B), and Fentanyl (Group F).
Results: The demographic profile with regard to age ,gender, ASA grading, average
duration of surgery were comparable in all the groups. The onset of block , mean time
for onset of motor blockade,mean time for sensory regression, mean time for regression
to bromage ‘1’ , mean duration of analgesia was the difference between the groups was
statistically significant.Intraoperative heart rates were comparable among the two
groups (p<0.005). isolated incidents of Bradycardia were noticed – but were neither
statistically significant nor clinically significant. There was gradual fall in the SBP and
DBP towards 30 minutes into surgery followed by a stable state .Both the groups were
comparable (p>0.05) with regard to their MAP, although hypotension was noticed in
both the categories of patients.All the adverse events were mild in nature which
required no intervention. No episodes of respiratory depression, dry mouth, PDPH were
noted in any of the subject in both the groups.
Conclusions: Intrathecal Buprenorphine (60mcg) is superior over intrathecal Fentanyl
(25mcg) as an adjuvant to Intrathecal hyperbaric 0.5% Bupivacaine when prolongation
of spinal anaesthesia is desired.

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.