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Indian Journal of Anesthesia and Analgesia

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Modified Combined Spinal and Epidural Analgesia with Buprenorphine and Bupivacaine

Sujatha M Papireddy, Associate Professor, Dept of Anaesthesiology, Sri Devaraj Urs Medical College, R L Jalappa Hospital & Research Centre, Sri Devaraj Urs Academy of Higher Education and Research (SDUAHER), Kolar, Karnataka 563101, India. , Madhusudhana Ravi1 , Papireddy Sujatha M2 , Nelamangala Kiran3 , Krishnamurthy Dinesh4 , Gurunath Bhavana B5 , Swamy Lakshmi K6

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Indian Journal of Anesthesia and Analgesia 6(1):p 173-177, Jan-Feb 2019. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6119.25

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Madhusudhana Ravi, Papireddy Sujatha M, Nelamangala Kiran. Modified Combined Spinal and Epidural Analgesia with Buprenorphine and Bupivacaine. Indian J Anesth Analg. 2019;6(1):173-177.

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Abstract

Context: Combined spinal and epidural analgesia is performed by double space or single space technique. It can also be performed through single intervertebral space with a CSE needle or a Spinal needle which is the modified technique we planned. Aims: To compare the effect of different doses of epidural Buprenorphine with spinal Bupivacaine in terms of Onset and duration of Sensory & Motor Block; Duration of post operative analgesia with Visual analog scale. Settings and Design: It is a prospective randomised control study. Methods and Material: A total  of 30 patients who met the enrolment criteria were approached & written informed consent was obtained.Group A were given Buprenorphine in the dose of 4 micrograms per kg with 10 ml Normal saline for epidural and 15 mg of Bupivacaine for spinal and Group B given Buprenorphine in the dose of 6 micrograms per kg with 10 ml Normal saline for epidural and 15 mg of Bupivacaine for spinal. Statistical analysis used: Comparisons between numerical variables were made using Student’s t test or the Mann-Whitney U test, accordingly. To test for potential differences in onset neural block assessments of the two concentrations, a repeated measures analysis of variance (ANOVA) was applied. Results: There was significant increase of mean in Onset of Sensory Block (min) in groupA compared to group B. There was significant increase of mean in Time to two Segment Regression of Sensory Level (min) in groupB compared to groupA. Mean Duration of analgesia is significantly increased in group B compared to group A. Conclusions: CSE can be practised safely with Buprenorphine as additive to subarachnoid block with single needle technique offering good postoperative analgesia. 

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Madhusudhana Ravi, Papireddy Sujatha M, Nelamangala Kiran. Modified Combined Spinal and Epidural Analgesia with Buprenorphine and Bupivacaine. Indian J Anesth Analg. 2019;6(1):173-177.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6119.25

Keywords

Buprenorphine; Bupivacaine; Epidural; Spinal.

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