Comparison of Buprenorphine as an Adjuvant to Intrathecal Bupivacaine Vs. No Adjuvants for Lower Limbs Peripheral Vascular Disease Reconstruction Surgeries
Year: 2024
Type: article
Abstract: Background: Regional anesthesia techniques, such as spinal anesthesia, are commonly used in reconstructive surgeries for peripheral artery disease of the lower limbs. Unfortunately, these techniques are partially limited by the duration of action of local anesthetics. Among the numerous adjuncts to local anesthetics that prolong anesthesia, buprenorphine hydrochloride stands out as particularly promising. Methods and materials: Sixty patients, aged 64,46±7,12 years and classified as ASA III-IV, who required reconstructive surgery for peripheral artery disease of the lower limbs, were included in the study. The SA group (30 patients) received 0.5% hyperbaric bupivacaine, 3 ml, without the addition of an adjunct, while the SA + B group (30 patients) received 0.5% hyperbaric bupivacaine with 0.06 mg of buprenorphine hydrochloride. The duration of analgesia, the time of onset and regression of sensory and motor blockade, visual analog scale (VAS) scores, and any side effects were assessed. Results: The duration of analgesia was significantly prolonged in the SA + B group (381.63 ± 47.23 minutes) compared to the SA group (238.33 ± 32.27 minutes) (p < 0.002). The onset of sensory and motor blockade showed no significant differences between the groups. Visual analog scale (VAS) scores were lower in the SA + B group during the first 24 hours (p < 0.0214). The SA group exhibited a higher incidence of postoperative nausea and vomiting, hypotension, and postoperative nausea and vomiting (PONV), while the SA + B group had a higher incidence of bradycardia. Respiratory depression did not occur. Conclusions: The addition of buprenorphine hydrochloride to hyperbaric bupivacaine for intrathecal administration enhances the duration of spinal blockade and improves the quality of postoperative analgesia during the first 24 hours following reconstructive surgeries for peripheral artery disease of the lower limbs. A dose of 0.06 mg of buprenorphine prolongs the duration of sensory blockade with minimal complications, such as bradycardia, postoperative nausea and vomiting (PONV), hypotension, and urinary retention, which do not significantly affect the recovery process.
Authors: A. MASOODI, D. DZIUBA
Institution: Shupyk National Healthcare University of Ukraine
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4405850776