Use of epidural opioids for postop analgesia after abdominal hysterectomy: Comparison of bupivacaine 0.375% and bupivacaine 0.125% plus buprenorphine 0.3 Mg

Background: epidural administration of drugs,both opioids and non opioids for management of acute postoperative pain has gained wide spread popularity. aim: to assess the effect of buprenorphine administered together with bupivacaine into the epidural space,on the intensity and duration of postoperative pain relief and to assess the complications. methods: this study included 80 women who underwent hysterectomy by laparotomy. the operations were performed under general anesthesia. the epidural analgesia was given at the time of closure of peritoneal cavity. in the postoperative period,the epidural analgesia was given to the two groups as boluses,while assessing the intensity and duration of pain relief in both the groups. any complication relating to the opioids and bupivacaine was also noted. the effects on hemodynamics (blood pressure,heart rate) were also recorded. results: significant reduction in the intensity of pain was noted in the group b receiving bupivacaine plus buprenorphine as compared to group a receiving bupivacaine alone. no patient in the group b required the rescue analgesia and one patient developed respiratory depression. moreover lower values of mean arterial pressure were recorded in group a,whereas significantly slower heart rate were found in the 3rd,4th and 5th hour of post operative period in group b. conclusions: the addition of opioids along with the local anesthetic agents in epidural space improves the quality of analgesia by decreasing mean pain score and prolonging the duration of analgesia.