Trends in Clinical and Medical Sciences
Special issue: Recent developments of medical and surgical research (2023), pp. 1 – 7
ISSN: 2791-0814 (online) 2791-0806 (Print)
DOI: 10.30538/psrp-tmcs2023.si-rdmsr001
ISSN: 2791-0814 (online) 2791-0806 (Print)
DOI: 10.30538/psrp-tmcs2023.si-rdmsr001
A comparative study of analgesic efficacy of buprenorphine and fentanyl as an adjuvant with bupivacaine in open cholecystectomy under thoracic epidural anaesthesia
Babita Lahkar\(^{1}\), Vikramjit Baruah\(^{2}\), Nilotpal Das\(^{3}\) and Rishov Hazarika\(^{4,*}\)
\(^{1}\) Department of Anaesthesiology and Critical Care, Fakhruddin Ali Ahmed Medical College and Hospital, Barpeta, Assam–781301, India.
\(^{2}\) \quad Department of Anaesthesiology, Jorhat Medical College and Hospital, Jorhat, Assam- 785001, India.
\(^{3}\) Department of Anaesthesiology, Fakhruddin Ali Ahmed Medical College and Hospital, Barpeta, Assam–781301, India.
\(^{4}\) Department of Anaesthesiology, Diphu Medical College and Hospital, Assam, India.
Correspondence should be addressed to Rishov Hazarika at rishovhazarika19@gmail.com
Copyright © 2023 Babita Lahkar, Vikramjit Baruah, Nilotpal Das and Rishov Hazarika. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: January 1, 2023 – Accepted: February 8, 2023 – Published: February 28, 2023
Abstract
Background: Thoracic epidural analgesia (TEA) remains a critical tool for anaesthesiologists to use in acute pain management. Present study was aimed to investigate the analgesic effect of buprenorphine and fentanyl as adjuvant with bupivacaine in thoracic epidural anaesthesia in patients undergoing open cholecystectomy.
Material and Methods: Present study was prospective, randomized, blinded study, conducted patients 18-50 years, of either sex, ASA physical status I and II, posted for elective open cholecystectomy under thoracic epidural anaesthesia. The patients were randomly allocated into 2 groups, A (buprenorphine) or B (fentanyl) of 30 each.
Results: Onset of analgesia in group A was 5.97 min while that of group B is 5.43 min at T10 level. There was no difference in the onset of analgesia between the two groups. Mean duration of analgesia of group A is 701.53 min while that of group B is 477.17 min, which is statistically significant with p value <0.0001. So, duration of analgesia is higher in buprenorphine compared to fentanyl as an adjuvant with bupivacaine in thoracic epidural anaesthesia. Mean two segment regression time of group A is 129.96 min while that of group B is 120.7 min, which is statistically significant with p value 0.0057. VAS is statistically significant in group B at 6th ,12th and 20th hrs. In the Group A, 20 % patients show nausea and 10% shows vomiting, while in the group B, 10% complained of nausea and 36.67% complained of pruritus.
Conclusion: Open cholecystectomy cases can be done under thoracic epidural anaesthesia with 0.5% bupivacaine and buprenorphine or fentanyl as an adjuvant. Buprenorphine having prolong duration of analgesia can be better than fentanyl even in postoperative period.
Material and Methods: Present study was prospective, randomized, blinded study, conducted patients 18-50 years, of either sex, ASA physical status I and II, posted for elective open cholecystectomy under thoracic epidural anaesthesia. The patients were randomly allocated into 2 groups, A (buprenorphine) or B (fentanyl) of 30 each.
Results: Onset of analgesia in group A was 5.97 min while that of group B is 5.43 min at T10 level. There was no difference in the onset of analgesia between the two groups. Mean duration of analgesia of group A is 701.53 min while that of group B is 477.17 min, which is statistically significant with p value <0.0001. So, duration of analgesia is higher in buprenorphine compared to fentanyl as an adjuvant with bupivacaine in thoracic epidural anaesthesia. Mean two segment regression time of group A is 129.96 min while that of group B is 120.7 min, which is statistically significant with p value 0.0057. VAS is statistically significant in group B at 6th ,12th and 20th hrs. In the Group A, 20 % patients show nausea and 10% shows vomiting, while in the group B, 10% complained of nausea and 36.67% complained of pruritus.
Conclusion: Open cholecystectomy cases can be done under thoracic epidural anaesthesia with 0.5% bupivacaine and buprenorphine or fentanyl as an adjuvant. Buprenorphine having prolong duration of analgesia can be better than fentanyl even in postoperative period.
Keywords:
Buprenorphine; Fentanyl; Bupivacaine; Open cholecystectomy; Thoracic epidural anaesthesia.