European Journal of Cardiovascular Medicine

Background: Subarachnoid block is one of the commonest local anesthetic technique and would probably maintain its place in the developing countries because of simplicity minimal skill requirement, onset, economy and minimum post-operative complications. The use of neuraxial opioids has increased dramatically in recent years augmenting the analgesia produced by local anesthetics like bupivacaine by binding directly to the opioid receptors. The aim of the current study is to compare the efficacy of opioids Buprenorphine and Fentanyl as adjuvants to 0.5% hyperbaric bupivacaine in spinal anaesthesia for lower limb and lower abdominal surgeries. Materials and methods: This study comprised of 70 patients, of ASA grades I– II, between the age group 18 and 60 years, planned for lower limb and lower abdominal surgeries who were randomly divided into B group(n=35) & F group(n=35). Group B received intrathecal 60μg of buprenorphine with 3.5cc (15mg) of 0.5% hyperbaric Bupivacaine. Group F received intrathecal 25μg of fentanyl with 3.5cc (15mg) of 0.5% hyperbaric Bupivacaine. Onset of sensory block and motor block, two segment regression, duration of sensory & motor block, duration of analgesia, haemodynamic changes and side effects were recorded. Result: Time of onset of sensory (4.2±1.3 vs 4.5±1.07 in mins) & motor blockade (7.4±1.3 vs 7.8±2.5 in mins) were similar and comparable in both buprenorphine and fentanyl groups. Duration of 2 segment regression time of sensory block was comparatively longer in buprenorphine group (125±8.8 in mins) compared to fentanyl group (100±10.9 in mins). Duration of sensory blockade was longer in buprenorphine group compared to fentanyl group (280±17.5 vs 195±21.12in mins). Duration of motor blockade too was longer in buprenorphine group compared to fentanyl group(165±10.8vs155±9.5 in mins).Duration of perioperative analgesia was significantly higher in buprenorphine group(355±30.5 vs 254±27.7 in mins).Hemodynamic parameters were comparable between the two groups. The mean Vas pain score in the first 12 hours postoperatively were comparable between both the groups and statistically insignificant. Time of first voiding was longer in buprenorphine group compared to fentanyl group (282±25.35 vs 273±30.20 in mins). Adverse effects between both the groups were comparable. Conclusion: The duration of sensory block, motor block,2 segment sensory regression time and perioperative analgesia was longer in buprenorphine group compared to fentanyl group. Hence Buprenorphine was considered as superior opioid adjuvant to local anesthetic for spinal anaesthesia with better efficacy and potency compared to fentanyl.