Comparative Study of Intrathecal Bupivacaine with Buprenorphine and Bupivacaine with Tramadol
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2017, Vol 4, Issue 4
Abstract
Aim: The aim of the study is to compare the following factors in two groups i.e., Hyperbaric bupivacaine 0.5% and Buprenorphine 60mcg (GROUP B) and Hyperbaric bupivacaine 0.5% and Tramadol 25mg (GROUP T). Patients and Methods: Inpatients, posted for major surgeries, below umbilical level, in Osmania general hospital and Govt. maternity Hospital, Hyderabad were choosen for the study. Inclusion Criteria: ASA physical status, class I and II, Age between 1860 years of either sex. Exclusion Criteria: Emergency surgery, deformities of spine, hypersensitivity to any of drugs, contraindications to spinal anaesthesia, patient refusal, bleeding diathesis. Results: A total of 100 patients of ASA Grade 1 and 2, between the age group of 1865 years who were undergoing lower limb and lower abdominal (Below umbilical) surgeries included in the study. They were randomized into two groups group B and group T which were given 3ml of 0.5% hyperbaric bupivacaine + 60 mcg of buprenorphine and 3ml of 0.5% hyperbaric bupivacaine + 25 mg of tramadol respectively. Preanesthetic checkup was done one day prior to the surgery. Patients were evaluated for any systemic diseases and laboratory investigations recorded. The procedure of SAB was explained to the patients and written consent was obtained. The patients were educated about the use of visual analogue scale. Preparation of patients included period of overnight fasting. Patients were premedicated with Tab.Rantac 150mg and Tab.Alprazolam0.5mgH/S. Time of onset of sensory block was tested with pin prick which was not significantly differed in both the groups but duration of sensory blockade (225.68±41.88 min), motor block (204.58±34.45 min) and duration of analgesia (291±33.7 min) were more with buprenorphine than tramadol which were 187.32±8.31, 153.32±7.93, 169.34±10.51 respectively. Heart rate, blood pressure, respiratory rate, saturation all were comparable in both the groups throughout the intraoperative period. Intraoperatively sedation score was assessed using Modified Ramsay Sedation Scale and there was higher incidence of sedation with Buprenorphine group. Nausea and vomiting were significantly higher in group T, with p value <0.001. Hypotension and bradycardia were more in group B which is statistically insignificant. Sedation scores were higher at 30 min in group B which was statistically insignificant with p=0.04, and higher again at 60 min and 90 min which is statistically significant with p value <0.01. At 120 min sedation scores were slightly higher in group T, but statistically insignificant with p value 0.67. sedation scores at 150 min and 180 min in two groups were comparable and statistically insignificant with p value 1. In our study postoperative analgesia was assessed by VAS at 6hr, 12hr, 18hr, and 24hr. The scores were lower in buprenorphine group than tramadol group which was statistically highly significant with p values < 0.001.Conclusion: To conclude, Buprenorphine (60 mcg) seems to be an attractive alternative to tramadol (25 mg) as an adjuvant to spinal bupivacaine in surgical procedures. It provides good quality of intraoperative analgesia, haemodynamically stable conditions, and excellent quality of postoperative analgesia. Hence, Buprenorphine seems to be a better choice as Intrathecal adjuvant with Bupivacaine when compared with Tramadol.
Authors and Affiliations
N. Sumathi
Keywords
Related Articles
- EP ID EP472276
- DOI 10.21088/ijaa.2349.8471.4417.5
- Views 80
- Downloads 0
Evaluation of Perioperative outcomes of Delayed Recovery Cases from GA and their Correlation with Standard Anaesthesia Scoring Systems: An Observational Study
Context: The critical period for a patient who was given general anaesthesia is the time during immediate recovery from anaesthesia. The PACU is a dynamic entity that greatly benefits the delayed recovery patients from r...
A Prospective Comparative Study of 0.5% Levobupivacaine versus 0.5% Ropivacaine in Supraclavicular Brachial Plexus Block
Background: Levobupivacaine is a s enantiomer of bupivacaine has been introduced in clinical practise in India, with lower cardio toxicity and neurotoxicity in comparison to bupivacaine [7,8]. We have designed present st...
Haemodynamic Responses to Laryngoscopy and Intubation in Patients Undergoing Craniotomy: Comparison between Macintosh and Mccoy Laryngoscope Blades, with Monitoring of Entropy
Aim: To compare the haemodynamic responses, during laryngoscopy and intubation, using Macintosh and McCoy blades, in patients of ASA grades I and II, undergoing craniotomy for supratentorial lesions, under general anaest...
Therapeutic Efficacies of Dexmedetomidine and Tramadol on Post Subarachnoid Block Shivering: A Prospective Study
Background and Aim: Shivering is a physiological response to core hypothermia in an attempt to raise the metabolic heat production. Non-pharmacological methods using equipment to maintain normal temperature of the body a...
Ultrasound-Guided Transverse Abdominis Plane Block Using Bupivacaine 0.25% vs Ropivacaine 0.2% For Post-Operative Analgesia in Caesarean Section
Introduction: Present study was conducted to compare the analgesic efficacy of 0.25% Bupivacaine and 0.2% Ropivacaine in Transverse Abdominis Plane (TAP) block under ultrasound guidance as a part of a multimodal analgesi...