Epidural buprenorphine in management of pain in multiple rib fractures

Govindarajan, Ramasamy; Bakalova, T; Michael, R; Ar, Amos

doi:10.1034/j.1399-6576.2002.460605.x

Cited by 27 publications

(14 citation statements)

References 22 publications

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“…Overall, it appeared that pain reduced faster and in a similar pattern for participants in the experimental group compared with participants in the control group who, in turn, experienced ups and downs in their experience of pain reduction. Many studies have shown the effectiveness of analgesics given for pain control in patients with rib fractures [5,7,29]. In the present study, it appeared that the active cycle of breathing techniques (ACBT) reduced the level of pain.…”

Section: Acbt Controlmentioning

confidence: 69%

Active cycle of breathing techniques contributes to pain reduction in patients with rib fractures

et al. 2010

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Section: Acbt Controlmentioning

confidence: 69%

Active cycle of breathing techniques contributes to pain reduction in patients with rib fractures

et al. 2010

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“…[1415] In all three groups, 100% patients had analgesia till two hours. 50% of patients had analgesia up to 6 hours in group I, 3 hours in group II and 17 hours in group III.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2010

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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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“…23 Addition of buprenorphine intrathecally or epidurally provides a good postoperative analgesia without prolonged motor block. 14,15 A study by Shaloo Ipe et al observed that 150mcg buprenorphine was not as effective as 300 mcg buprenorphine given epidurally where the duration of analgesia was highest, though the analgesic effect of buprenrphine given intrathecally was quite effective with 50% patients showing the effect for 6 hours. 16 Some investigators have demonstrated that by using buprenorphine alone epidurally, in doses of 1 to 4 mg, varying durations of pain relief ranging from 2.5 to 9 hours are observed.…”

Section: Discussionmentioning

confidence: 99%

Comparative study of intrathecal bupivacaine 0.5% with bupivacaine 0.5% and buprenorphine low dose for postoperative analgesia in lower abdominal surgeries

Rao¹,

Prakash²

2016

Int Surg J

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INTRODUCTIONPain is one of the most common and uncomfortable consequences of a surgery, feared by all. Effective and rapid relief from pain is always a challenge, but is necessary for alleviating nocioception -induced responses like endocrine metabolic responses to surgery, autonomic reflexes with adverse effects on organ function, reflexes leading to muscle spasm, and other undesirable results. 1 ABSTRACT Background: Opiods, like buprenorphine, have been widely used for providing pain relief postoperatively and their advantages of neuraxial narcotics over systemic narcotics are well established. When compared to local anaesthetics, they offer good analgesia while allowing early ambulation of the patient by sparing sympathetic and motor nerves. This study was conducted to compare the efficacy of bupivacaine alone and in combination with low dosage of buprenorphine. Methods: 80 patients between the ages 20-60 undergoing lower abdominal surgeries were divided into 2 groups of 40 each after taking detailed history and undergoing the necessary preliminary tests. Patients in the Group I was given 17.5mg of 0.5% Hyperbaric Bupivacaine along with 60ug of Buprenorphine. The patients in Group II received 17.5mg of 0.5% Hyperbaric Bupivacaine. Onset and duration of analgesia were recorded. The efficacy of analgesia was recorded based on VAS score. Side effects, time of recovery also were noted. Results: In this retrospective study we found that incidence of colorectal carcinoma is more between 40-60 years of age with male predominance; lymph node metastasis is more than metastasis in any other sites. CT scan can diagnose lymphatic metastasis and infiltration in surrounding tissue more accurately. Percentage of sphincter saving procedure was low in rectal malignancies in our study. Conclusions: The onset of analgesia was within 5 minutes in 100% of the cases in Group I while in Group II it was upto 9 minutes. The mean of the duration of analgesia was 15h 33mins and 3 h 18 mins in Group I and II respectively. The pain scoring through VAS in the 2 groups showed that most of the patients in Group I had 0 to mild pain till about 12 hours while in Group II the analgesic effect was felt only till the first 2 hours. The supplementary analgesic was required on Group II within 4 hours post operatively while in Group I the requirement was only after 12 hours. The major side effect among the patients was vomiting and nausea in 12 patients in Group I followed by urinary retention in 6 patients. While in Group II only 6 patients had nausea and no other side effect. Pruritis was observed in 1 patient in Group I Respiratory distress, drowsiness, headache and backache was not observed in any of the cases.

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Epidural buprenorphine in management of pain in multiple rib fractures

Cited by 27 publications

References 22 publications

Active cycle of breathing techniques contributes to pain reduction in patients with rib fractures

Active cycle of breathing techniques contributes to pain reduction in patients with rib fractures

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

Comparative study of intrathecal bupivacaine 0.5% with bupivacaine 0.5% and buprenorphine low dose for postoperative analgesia in lower abdominal surgeries

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