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Category: Volume 08 Issue 11 November 2020
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Title: Comparative Study of Epidural Injection of 0.5% Bupivacaine with Buprenorphine and 0.5% Bupivacaine with Fentanyl for Lower Limb Surgeries

Authors: Dr Bala Muralikrishna Muppala, Dr Konduru Sindhura, Dr Kalyan Chakravarthy P

 DOI: https://dx.doi.org/10.18535/jmscr/v8i11.98

Abstract

Background: Epidural anaesthesia is one of the best accepted techniques for lower limb surgeries as it provides good sensory and motor block and decreases adverse physiologic responses to surgery such as autonomic hyperactivity, cardiovascular stress, increased metabolic rate, pulmonary dysfunction and immune system dysfunction. In present day practice of anaesthesiology, bupivacaine is the most commonly used drug for regional anaesthesia. To improve quality of analgesia and to prolong duration of action many adjuvants have been tried.

Aim: This study compared 0.5% bupivacaine with buprenorphine and 0.5% bupivacaine with fentanyl in lower limb surgeries under epidural anaesthesia.

Materials & Methods: A randomized prospective observational study includes 60 patients of ASA I&II aged 18-60 years, posted for elective lower limb surgeries under epidural anaesthesia. Patients were randomly divided in to two groups of 30 each. Group A received

0.5% Bupivacaine 15ml (75mg) +0.5m l(150 mcg) Buprenorphine+0.5ml normal saline made to a total of 16ml. Group B received 0.5% Bupivacaine+ 1ml(50mcg) Fentanyl. vitals were monitored. Onset of sensory and motor blockade, quality and duration of postoperative analgesia, side effects were recorded.

Results: The onset of sensory blockade and motor blockade was faster in group B compared to group A. Duration of analgesia was significantly longer in Group A. The incidence of Nausea and vomiting was more in group A. No significant haemodynamic changes were observed in both the groups.

Conclusion: Epidural injection of 0.5% bupivacaine with 150mcg buprenorphine is better in providing prolonged satisfactory postoperative analgesia as compared to Fentanyl.

Keywords: Epidural anaesthesia, bupivacaine, buprenorphine, fentanyl.

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Corresponding Author

Dr Bala Muralikrishna Muppala

Post Graduate, Department of Anaesthesiology, GEMS