ABSTRACT
Introduction: Epidural anaesthesia and analgesia hasjustified use in the perioperative care of high-risk surgicalpatients, as they give better analgesia, and also improvedoutcome. Thoracic Epidural analgesia is an excellent methodof postoperative and post injury pain control in proceduresinvolving significant thoracic and abdominal injury weathertraumatically or surgically induced. Though Bupivacaine isconsidered to be the drug of choice, many other agents arebeing used for epidural anesthesia.Material and Methods: This study was carried out on 105ASA grade I and II nulliparous patients, between 20 to 70 yearsof age undergoing laparotomy, voluntary donor nephrectomyand renal surgeries. They were randomly divided in theBuprenorphine, Bupivacaine and Fentanyl Groups. Quality ofanalgesia and post-operative complications were monitored.Results: Analgesic failure was observed in all the threeGroups. But complete pain relief was better in theBuprenorphine Group. Also, complications (hypotension,bradycardia, sedation) were less in the Buprenorphine Groupthan in the Bupivacaine and Fentanyl Groups.Conclusion: Buprenorphine is safer and provides betterquality analgesia than Bupivacaine and Fentanyl.
ABSTRACT
Introduction: Epidural anaesthesia and analgesia hasjustified use in the perioperative care of high-risk surgicalpatients, as they give better analgesia, and also improvedoutcome. Thoracic Epidural analgesia is an excellent methodof postoperative and post injury pain control in proceduresinvolving significant thoracic and abdominal injury weathertraumatically or surgically induced. Though Bupivacaine isconsidered to be the drug of choice, many other agents arebeing used for epidural anesthesia.Material and Methods: This study was carried out on 105ASA grade I and II nulliparous patients, between 20 to 70 yearsof age undergoing laparotomy, voluntary donor nephrectomyand renal surgeries. They were randomly divided in theBuprenorphine, Bupivacaine and Fentanyl Groups. Quality ofanalgesia and post-operative complications were monitored.Results: Analgesic failure was observed in all the threeGroups. But complete pain relief was better in theBuprenorphine Group. Also, complications (hypotension,bradycardia, sedation) were less in the Buprenorphine Groupthan in the Bupivacaine and Fentanyl Groups.Conclusion: Buprenorphine is safer and provides betterquality analgesia than Bupivacaine and Fentanyl.
ABSTRACT
There are many methods for postoperative pain relief. For example,intramusoular or in- travenous administration of analgesics,nerve block,wound infiltration or intravenous injaction with local anesthetics, epidural or intrathecal injection of opioids or local anesthetics, TENS, cryoanalgesia, psychological support are available, We managed postoperative pain by means of intrathecal morphine injection or epidural morphine with bupivacaine mixture administration. In the group 1, morphine 0.2mg was injected intrathecally just after the operation. In the group 2, the mixture of morphine with bupivacaine was infused into epidural space continuously for 3days. The results were as follows; 1. The pain score was significantly decreased in group 2 compared to group 1.(P<0.05) 2. In group 1,there was signficantly more itehing sensation than in group 2.(P<0.05), but there were no significst differences in other complications 3. There was no significant difference in gas passing time. 4. The feeling of satisfaction was high in both groups,and there was no significant difference. 5. It was technically more difficult and the cost was higher in group 2.
Subject(s)
Analgesics, Opioid , Anesthetics, Local , Bupivacaine , Epidural Space , Injections, Spinal , Morphine , Pain, Postoperative , Sensation , Transcutaneous Electric Nerve StimulationABSTRACT
The analgesic effect of epidural pentazocine for the postoperative pain relief was studied. In our previous report, we used the pentazocine diluted to normal saline, however in this study, pentazocine was diluted with distilled water and made to 10ml mixture. Fourty patients were divided into four groups (n=10) as follows: Group I: control, distilled water of 10 ml, Group II: pentazocine 0.2 mg/kg, Group III: pentazocine 0. 3mg/kg, Group IV: pentazocine 0.4mg/kg, all pentazocine groups were diluted to 10ml of distilled water. We have carried out the study to see the effects on the time of peak analgesia, the duration of analgesia, the degree of analgesia and the side effects. The results are as follows: 1) Seven cases (70%) in the control group showed rapid but short duration of analgesia. 2) The pentazocine 0.3 and 0.4 mg/kg groups were significantly different from the control group (p< 0.05). 3) In the pentazocine 0.3 and 0.4 mg/kg groups, the time of peak analgesia occured 8-9 minutes, the duration of analgesia was 10 hours and the degree of analgesia showed moderate to good degree. 4) Nine cases (90%) in the control group complained of back pain during epidural injection and 16 cases (53%) in the pentazocine group conplained of drowsiness.