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A comparative study of intrathecal and epidural buprenorphine using combined spinal-epidural technique for caesarean section

Neuraxial opioids provide excellent analgesia intraoperatively and postoperatively while allowing early ambulation of the patient by sparing sympathetic and motor nerves. A prospective, randomised double blind study was conducted involving 90 patients of ASA 1 physical status coming for elective ces...

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Detalles Bibliográficos
Autores principales: Ipe, Shaloo, Korula, Sara, Varma, Sreelatha, George, Grace Maria, Abraham, Saramma P, Koshy, Leena Rachel
Formato: Texto
Lenguaje:English
Publicado: Medknow Publications 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2933477/
https://www.ncbi.nlm.nih.gov/pubmed/20885865
http://dx.doi.org/10.4103/0019-5049.65359
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author Ipe, Shaloo
Korula, Sara
Varma, Sreelatha
George, Grace Maria
Abraham, Saramma P
Koshy, Leena Rachel
author_facet Ipe, Shaloo
Korula, Sara
Varma, Sreelatha
George, Grace Maria
Abraham, Saramma P
Koshy, Leena Rachel
author_sort Ipe, Shaloo
collection PubMed
description Neuraxial opioids provide excellent analgesia intraoperatively and postoperatively while allowing early ambulation of the patient by sparing sympathetic and motor nerves. A prospective, randomised double blind study was conducted involving 90 patients of ASA 1 physical status coming for elective cesarean section to evaluate the analgesic effect of neuraxial buprenorphine. They were allocated into three groups. Spinal local anaesthetic was used as the main stay of anaesthesia for surgery and spinal and epidural analgesia with opioids continued as the main stay for postoperative analgesia. All the groups were given 0.5% Bupivacaine intrathecally for the surgery. Besides this, group I was given 150 mcg Buprenorphine intrathecally and group II and III were given 150 mcg and 300 mcg Buprenorphine respectively, epidurally. In the present study, we observed that 150 mcg of Buprenorphine given intrathecally provided much longer duration of analgesia compared to 150 mcg of Buprenorphine given epidurally. Increasing the epidural dose of Buprenorphine from 150 mcg to 300 mcg proved to produce prolonged analgesia comparable to intrathecal Buprenorphine without compromising patient safety and neonatal outcome. The minor side effects were more with intrathecal Buprenorphine than epidural Buprenorphine. We concluded that 300 mcg of Buprenorphine epidurally is equianalgesic to 150 mcg Buprenorphine intrathecally.
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spelling pubmed-29334772010-09-30 A comparative study of intrathecal and epidural buprenorphine using combined spinal-epidural technique for caesarean section Ipe, Shaloo Korula, Sara Varma, Sreelatha George, Grace Maria Abraham, Saramma P Koshy, Leena Rachel Indian J Anaesth Clinical Investigation Neuraxial opioids provide excellent analgesia intraoperatively and postoperatively while allowing early ambulation of the patient by sparing sympathetic and motor nerves. A prospective, randomised double blind study was conducted involving 90 patients of ASA 1 physical status coming for elective cesarean section to evaluate the analgesic effect of neuraxial buprenorphine. They were allocated into three groups. Spinal local anaesthetic was used as the main stay of anaesthesia for surgery and spinal and epidural analgesia with opioids continued as the main stay for postoperative analgesia. All the groups were given 0.5% Bupivacaine intrathecally for the surgery. Besides this, group I was given 150 mcg Buprenorphine intrathecally and group II and III were given 150 mcg and 300 mcg Buprenorphine respectively, epidurally. In the present study, we observed that 150 mcg of Buprenorphine given intrathecally provided much longer duration of analgesia compared to 150 mcg of Buprenorphine given epidurally. Increasing the epidural dose of Buprenorphine from 150 mcg to 300 mcg proved to produce prolonged analgesia comparable to intrathecal Buprenorphine without compromising patient safety and neonatal outcome. The minor side effects were more with intrathecal Buprenorphine than epidural Buprenorphine. We concluded that 300 mcg of Buprenorphine epidurally is equianalgesic to 150 mcg Buprenorphine intrathecally. Medknow Publications 2010 /pmc/articles/PMC2933477/ /pubmed/20885865 http://dx.doi.org/10.4103/0019-5049.65359 Text en © Indian Journal of Anaesthesia http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Investigation
Ipe, Shaloo
Korula, Sara
Varma, Sreelatha
George, Grace Maria
Abraham, Saramma P
Koshy, Leena Rachel
A comparative study of intrathecal and epidural buprenorphine using combined spinal-epidural technique for caesarean section
title A comparative study of intrathecal and epidural buprenorphine using combined spinal-epidural technique for caesarean section
title_full A comparative study of intrathecal and epidural buprenorphine using combined spinal-epidural technique for caesarean section
title_fullStr A comparative study of intrathecal and epidural buprenorphine using combined spinal-epidural technique for caesarean section
title_full_unstemmed A comparative study of intrathecal and epidural buprenorphine using combined spinal-epidural technique for caesarean section
title_short A comparative study of intrathecal and epidural buprenorphine using combined spinal-epidural technique for caesarean section
title_sort comparative study of intrathecal and epidural buprenorphine using combined spinal-epidural technique for caesarean section
topic Clinical Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2933477/
https://www.ncbi.nlm.nih.gov/pubmed/20885865
http://dx.doi.org/10.4103/0019-5049.65359
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