Borkotoky Smitirupa, Karan Daisy, Banerjee Swarna, Biswal Prerna, Moda Nupur
Department of Anesthesiology, Institute of Medical Sciences and Sum Hospital, Bhubaneswar, Odisha, India.
Anesth Essays Res. 2022 Jan-Mar;16(1):121-126. doi: 10.4103/aer.aer_39_22. Epub 2022 Jul 6.
Longer duration of analgesia, ceiling effect on respiratory depression, and the antihyperalgesia property make buprenorphine a good adjuvant for managing moderate-to-severe postoperative pain.
The aim of this study is to evaluate the onset and duration of postoperative analgesia of three different doses of buprenorphine of 60, 100, and 150 μg given intrathecally along with hyperbaric bupivacaine in patients undergoing lower limb surgeries.
This prospective observational study was carried out in the anesthesia department of a tertiary care hospital.
The study included 90 patients of either sex, aged 18-60 years, scheduled for elective lower limb surgery under subarachnoid block. Patients were randomly allocated into three groups (30 each) receiving different doses of buprenorphine. In addition, all patients received 3 mL of 0.5% hyperbaric bupivacaine.
The Chi-square test or Fisher's exact test was used to find out the association between the categorical variables. The association of quantitative variables between the groups was assessed by Kruskal-Wallis test while within the groups was assessed by repeated-measures analysis of variance test.
Baseline characteristics such as age, gender, and American Society of Anesthesiologist physical status classification were comparable among the three groups. Sensory block, motor block, and total duration of analgesia were significantly higher with higher doses of buprenorphine. The mean difference in the duration of analgesia was comparable in patients receiving 100 μg (720 min) and 150 μg (825 min) of buprenorphine. Bradycardia as a side effect was only in patients receiving 150 μg of buprenorphine.
Risk-benefit of different doses of buprenorphine suggests that 100 μg may be the ideal dose for a better quality of spinal block and maintaining hemodynamic stability.
布托啡诺具有较长的镇痛持续时间、对呼吸抑制的封顶效应以及抗痛觉过敏特性，使其成为管理中重度术后疼痛的良好辅助药物。
本研究旨在评估在接受下肢手术的患者中，鞘内注射三种不同剂量（60、100和150μg）的布托啡诺与重比重布比卡因联合使用时术后镇痛的起效时间和持续时间。
这项前瞻性观察性研究在一家三级护理医院的麻醉科进行。
该研究纳入了90例年龄在18 - 60岁之间、计划在蛛网膜下腔阻滞下进行择期下肢手术的患者，性别不限。患者被随机分为三组（每组30例），接受不同剂量的布托啡诺。此外，所有患者均接受3mL 0.5%的重比重布比卡因。
采用卡方检验或Fisher精确检验来确定分类变量之间的关联。组间定量变量的关联通过Kruskal-Wallis检验评估，而组内则通过重复测量方差分析进行评估。
三组患者的年龄、性别和美国麻醉医师协会身体状况分级等基线特征具有可比性。布托啡诺剂量越高，感觉阻滞、运动阻滞和镇痛总持续时间显著越长。接受100μg（720分钟）和150μg（825分钟）布托啡诺的患者，其镇痛持续时间的平均差异相当。心动过缓作为一种副作用仅出现在接受150μg布托啡诺的患者中。
不同剂量布托啡诺的风险效益表明，100μg可能是获得更好脊髓阻滞质量和维持血流动力学稳定的理想剂量。
