Intrathecal buprenorphine-an adjuvant to 0.5% racemic bupivacaine for subarachnoid block in elective open gynaecological surgeries.

Background & objectives: Subarachnoid block is commonly used for lower abdominal and lower limb surgeries. Racemic bupivacaine 0.5% is commonly used in spinal anaesthesia. Various additives are added for various reasons. Buprenorphine is a synthetic opioid analgesic with a mixed agonistantagonist action and is a commonly used one such adjuvant. This study has been designed to evaluate the sensorimotor effects, onset and duration of analgesia, vital parameters and any adverse effects of addition of buprenorphine (60 µg) to 3 ml of 0.5% racemic bupivacaine intrathecally for elective open gynaecological surgeries. Methods: In this randomized, double-blind prospective study, 60 patients (age 18-60years) of ASA I and II were randomized into two groups: group BO and BB (n=30). Group BO received a 3ml of 0.5% racemic bupivacaine (15 mg) only and Group BB received 3ml of 0.5% racemic bupivacaine along with 60mcg buprenorphine. Results: It was found that the onset of sensory block upto T10 and motor block is statistically significantly faster in group BB (109.33 sec and 153.5 sec) over group BO (133 sec and 167.67 sec). The mean time for two segment regression, the mean time to sensory regression to L1, the mean duration of analgesia and the mean duration of motor blockade is significantly prolonged in Group BB (106.67 min, 322 min, 343 min, x 330.5 min) over Group BO (132.67 min, 259.67 min, 290.67 min, 253.34 min) with p<0.001. Conclusion:60µg of Buprenorphine used as an adjuvant in subarachnoid block was found to be a better adjuvant in prolonging the sensory and motor blockade intraoperatively and the duration of postoperative analgesia compared than 0.5% bupivacaine alone, without significant adverse effects making it a good option in prolonged surgeries and for good post-operative analgesia. [ABSTRACT FROM AUTHOR]

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