Key result
The addition of buprenorphine to bupivacaine in spinal anesthesia for cesarean delivery prolonged the mean time to request for analgesia to 825.33 minutes compared to 166.78 minutes with bupivacaine alone.
Why the study?
Does the addition of buprenorphine to bupivacaine prolong analgesia duration in patients undergoing elective cesarean delivery under spinal anesthesia?
RCT (n=100)
No
Does the addition of buprenorphine to bupivacaine prolong analgesia duration in patients undergoing elective cesarean delivery under spinal anesthesia?
Absolute Event Rate: 825.33% vs 166.78%
p-value: p=0.182
Adding buprenorphine to bupivacaine for spinal anesthesia in cesarean delivery reduces the need for postoperative analgesia within 24 hours.
May support intrathecal buprenorphine for longer post-cesarean analgesia; leaves open confirmation in larger randomized trials.
BACKGROUND: Spinal anesthesia has been the preferred type of anesthesia for cesarean sections and other obstetric operations. Bupivacaine has been used for this purpose being long acting. Lately various narcotic analgesics have been added to prolong the analgesia and reduce the expected toxicity of bupivacaine alone. We evaluated the duration of analgesia achieved with the combination of bupivacaine-buprenorphine versus bupivacaine alone in cesarean delivery under spinal anesthesia. Methods: A comparative study was conducted at a tertiary care teaching healthcare center in Karachi, Pakistan. One hundred patients scheduled for elective cesarean section were enrolled and divided into two groups. Group A received 10 mg of hyperbaric bupivacaine 0.5% along with normal saline, while Group B received the same dose of bupivacaine along with buprenorphine 75 µg. Preoperative assessment, intraoperative procedures, and postoperative management were performed following standard protocols of our institution. Statistical analysis was conducted using independent t-tests and chi-square tests. Results: The findings revealed significantly longer mean time to request for analgesia in Group B compared to Group A (825.33 min vs. 166.78 min; P = 0.182), Only 14 patients in Group B (28%) required analgesia within 24 h, while all patients in Group A requested analgesia within that time frame (P = 0.0001). Moreover, an insignificantly lower incidence of hypotension and reduced need for phenylephrine administration was observed in Group B compared to Group A (P = 0.585). Group B also demonstrated a lower incidence of nausea (P = 0.380) and vomiting (P = 0.370) compared to Group A, but the difference was statistically not significant. Conclusion: This study suggests that the addition of buprenorphine to bupivacaine in spinal anesthesia for cesarean delivery provides prolonged analgesia, reduces the incidence of nausea and vomiting, and decreases the need for vasopressor administration. These findings support the potential benefits of using the bupivacaine-buprenorphine combination in cesarean deliveries. Key words: Cesarean Delivery; Opioids, Intrathecal; Anesthesia, Spinal; Bupivacaine; Buprenorphine; Analgesia, Duration Citation: Saleh M, Malik S, Memon GN, Rehman M. Comparative study on analgesia duration with bupivacaine-buprenorphine combination vs. bupivacaine alone for cesarean delivery. Anaesth. pain intensive care 2023;27(5):501−505; DOI: 10.35975/apic.v27i5.2303 Received: July 29, 2023; Reviewed: August 10, 2023; Accepted: August 10, 2023
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Memon et al. (2023) conducted an RCT in Cesarean delivery (n=100). Bupivacaine-buprenorphine vs. 10 mg hyperbaric bupivacaine 0.5% + normal saline was evaluated on Mean time to request for analgesia (minutes) (p=0.182). The addition of buprenorphine to bupivacaine in spinal anesthesia for cesarean delivery prolonged the mean time to request for analgesia to 825.33 minutes compared to 166.78 minutes with bupivacaine alone.
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