Study to Compare the Efficacy of Thoracic Epidural 0.125% Bupivacaine and 0.125% Bupivacaine with Buprenorphine for Postoperative Analgesia in Upper Abdominal Surgeries

Abstract

Kasturi Nirmala Devi1 , Desavanth Srinivas Naik2 , Kailashnath Reddy3

BACKGROUND Pain is a complex subjective experience which has proved difficult to measure in reproducible way and indwelling catheter facilitates further administration of analgesic doses for postoperative analgesia as and when required. We wanted to evaluate the quality and duration of analgesia produced by fixed dose of epidural bupivacaine 0.125% and fixed dose of epidural bupivacaine 0.125% with buprenorphine for post-operative analgesia in upper abdominal surgeries. METHODS Patients of ASA grade ?? and grade ????, aged between 20 - 60 yrs., of both sexes, who underwent upper abdominal surgeries were included in the study. Patients were randomly divided into two groups, group A (n=25) and group B (n=25). Group A patients received 8 ml of epidural 0.125% bupivacaine in normal saline and Group B patients 8 ml of 0.125% bupivacaine with 2 µg/Kg of buprenorphine in normal saline for postoperative analgesia. Onset and duration of analgesia, haemodynamic and respiratory parameters, side effects like nausea, vomiting, respiratory depression, pruritus, and motor blockade were recorded. RESULTS Group B patients had early onset of analgesia compared to Group A. Duration of analgesia was significantly longer in Group B than Group A (10.04 ± 2.25 vs 4.85 ± 0.64). The incidence of side effects like nausea, vomiting, pruritus, was more in Group B than Group A. No patient developed respiratory depression or motor blockade in either group. CONCLUSIONS Addition of buprenorphine to epidural bupivacaine produced superior analgesia than bupivacaine alone with fewer side effects.

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