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Study of 2-Chlorprocaine 1% with Adjuvants Fentanyl and Buprinorphine in Comparison with Plain 2-Chlorprocaine1% for Subarachnoid Blocks in Perianal Surgeries

Shivakumar K. Marulappa, Assistant Professor, Department of Anaesthesiology, Sri Devaraj Urs Medical College, R L Jalappa Hospital, SDUAHER, Tamaka, Kolar, Karnataka 563101, India. , Mamatha Mishra1 , Shivakumar K. Marulappa2 , Ravi Madhusudhana3

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Indian Journal of Anesthesia and Analgesia 5(10):p 1662-1667, Oct 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51018.12

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Abstract

  Introduction: This study aims at comparing the anaesthesia characteristics between Buprenorphine and Fentanyl when added as an adjuvant to intrathecal 2­Chloprocaine 1% in an attempt to prolong the duration of spinal analgesia post operatively and are compared with the plain 2­Chloprocaine 1% intrathecally for perianal and perineal surgeries. Methods: The study was
conducted on 63 patients divided into 3 groups. The control A was given 30mg (3 ml) of 2­Chloprocaine 1% with 0.5cc normal saline and study groups B and C were given 30mg (3ml) of 2­Chloprocaine 1% with 0.5cc (25µ) of Fentanyl and 0.2cc (60µ) of Buprenorphine with 0.3cc of normal saline respectively. Study included ASA I and II patients and were subjected to the following perennial and perineal surgeries like haemorrhoids, fissure­in­ano, fistula­in­ano, perianal and scrotal abscess, carcinoma rectum for rectal biopsy, hydrocele, phimosis. Standard spinal anaesthesia techniques were chosen for all patients including lateral position, midline approach with 25G quinke spinal needle. Results: There was no significant difference in time of onset of sensory block and motor blockade between the 3 groups and also no significant haemodynamic changes between the 3 groups. But there was a significant difference in mean total duration of analgesia and VAS score between 3 groups post operatively. Conclusion: The study shows that 2­Chloprocaine 1% provides an adequate block for perianal and perineal surgeries lasting 40­60 min. Addition of Buprenorphine 60µ and Fentanyl 25µ improves the quality of spinal anaesthesia and prolongs the duration of analgesia post operatively and Buprenorphine prolongation being much longer than Fentanyl.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51018.12

Keywords

Adjuvants; Ambulatory Surgeries; 2­Chlorprocaine.

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