comparison of epidural and intramuscular buprenorphine in patients following lower abdominal surgery

ABSTRACT

This Analytical study aimed to assess and compare the efficacy of Epidural route with n the duration of analgesia and degree of ostoperative pain relief in patients undergoing lower abdominal surgery. The objectives of this study were to compare the duration of analgesia in two regimens, compare the degree of pain relief in two regimens The study was conducted at general surgical wards I and II in Nishtar hospital Multan over a period of six months from 1st April - 30th September 2003. Sixty patients of either sex belonging to age range 40-60 years, of ASA grade I and II, undergoing elective lower abdominal surgery were included in this study. Patients having any clinical or biochemical evidence of systemic involvement were excluded from the study. Patients having local sepsis, or patients with history of allergy or sensitivity to buprenorphine or those suffering with fever during postoperative period were excluded. Sixty patients were included in this study, all were assigned to one of the two groups I and II, using non probability convenience sampling technique. Each group comprised of thirty patients. Group I received epidural Buprenorphine 0.3mg in 9 ml of normal saline, through epidural catheter Group II received parenteral Buprenorphine 0.3 mg. I/M deep into deltoid muscle. All patients underwent surgery under general anaesthesia, but no narcotic analgesia was given in preoperative or intraoperative period. Prior to induction in group I, epidural catheter was passed at L1-2 or L2-3 intervertebral space and at the time of closure of peritoneal cavity 0.3mg Buprenorphine, in 9 ml of normal saline was given in it; where as Group II was given injection Buprenorphine 0.3 mg IM deep into the deltoid muscle at the time of closure of peritoneal cavity" Patients were transfered to the HDU where they remained for 24 hours. Patients were instructed to ask for analgesia as soon as pain at rest returned. In postoperative period pain intensity was evaluated at 0, I, 4, 8,12,16,20,24 hrs interval after completion of operation using a 10 cm Visual Analogue Scale and with the help of McGill questionnaire. In group I, excellent analgesia of longer duration was noted, with no hemodynamic as well as immediate respiratory depressant effects. Moreover, drowsiness as compared to group II was much less