Title: Comparison of Epidural Fentanyl and Buprenorphine as Adjuvants to Bupivacaine in Lower Abdominal Surgeries: A Randomized Clinical Study
Authors: Dr Shibani Padhy M.B.B.S, M.D, Dr Prachi Kar MBBS, MD, PDCC, Dr Prasanna Kumar Mishra
DOI: https://dx.doi.org/10.18535/jmscr/v4i12.87
Abstract
Background: Epidural neuraxial opioids when added to local anaesthetics improves the onset and duration of analgesia. The present study was conducted to evaluate the safety and efficacy of epidural buprenorphine and fentanyl as adjuvants to epidural bupivacaine.
Methods: After taking written informed consent, 75 American society of anesthesiologist (ASA) grade I and II patients between 20-50 years undergoing elective lower abdominal surgery under epidural anaesthesia were enrolled for the study. The patients were randomly divided into 3 groups: group-B-(Received Bupivacaine 0.5% 20ml epidurally), group-BB-(Received Bupivacaine 0.5% 20ml+0.3mg buprenorphine epidurally), group-BF-(received Bupivacaine 0.5% 20ml+100μg fentanyl). Hemodynamic parameters and block characters like onset and duration of sensory analgesia, quality of analgesia, quality of motor block, and all side effects were noted. Statistical analysis was performed.
Results: The time to onset of sensory block was significantly lower in the epidural fentanyl group. The duration of analgesia was significantly prolonged with both adjuvants,more so with epidural buprenorphine. Incidence of side effects like sedation, nausea vomiting and urinary retention was higher in the epidural buprenorphine group. No patients had cardiovascular or respiratory depression.
Conclusions: Fentanyl and buprenorphine are safe and effective adjuvants to epidural bupivacaine, in patients undergoing lower abdominal surgeries with fentanyl being a better choice over buprenorphine in view of its faster onset of action,good quality analgesia and fewer side effects.
Keywords: Epidural, Buprenorphine, Fentanyl, Bupivacaine.
