Abstract
COMBINATION OF HYPERBARIC BUPIVACAINE WITH BUPRENORPHINE IN LOWER ABDOMINAL SURGERY - A COMPARATIVE STUDY

This study was conducted to compare the efficacy of hyperbaric Bupivacaine with Buprenorphine combination in lower abdominal surgery for prolonging the duration of postoperative analgesia. In this prospective, double blinded control study; 100 patients were randomly divided into two groups each of fifty, scheduled for lower abdominal and lower limb surgeries under spinal anesthesia. Group A patients were given with 2.5 ml of hyperbaric bupivacaine heavy (12.5 mg) of 0.5% with 0.5 ml of injection buprenorphine 50 µg. Group B patients were given with 2.5 ml of hyperbaric bupivacaine heavy (12.5 mg) of 0.5% with 0.5 ml of normal saline. Patients pulse rate, blood pressure, respiratory rate were recorded at 0 (basal) 15, 30, 45, 90 and 180 minutes. Postoperatively heart rate, blood pressure, respiratory rate and SP02 were monitored at 360 and 600 minutes. Onset of sensory block and pain was assessed by visual analogue scale (VAS) at 360 and 600 minutes postoperatively. Both the groups were comparable in age, sex, weight and height distribution. The mean age in study group were 37.3 ± 10.7 years with a mean height of 166.3 ± 8.9cms and mean weight of about 64.67 ± 8.1 kg. Whereas in control group the mean age is about 37.3 ± 10.7 years with a height of 170.8 ± 9.2cms and weight of about 63.2 ± 7.0 kg, comprising of 50 males and 50 female patients. The mean value of age, sex, weight and height were comparable and difference was not statistically significant. In the study group, the VAS scale was around I during the 90 and I80 minutes whereas in the control group the VAS scale was 1 at 90 minutes and 6.6 ± 2 at 180 minutes. Thus the rescue medication was given in the control group at 180 minutes, whereas in the study group, the VAS continued to be 1 during 360 minutes but increased to about 6.0 ± 2.3.at 600 minutes, where in any value about 6 was taken need for rescue medication. To conclude, low dose buprenorphine potentiates the action of bupivacaine in spinal anesthesia thereby decreasing the time taken for onset of analgesia, prolonging the duration of analgesia, delays postoperative pain and thus reduces analgesic requirement in the early postoperative period.