Document Detail


Buprenorphine enhances and prolongs the postoperative analgesic effect of bupivacaine in patients receiving infragluteal sciatic nerve block.
MedLine Citation:
PMID:  21042200     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Results from previous studies have shown favorable effects from the addition of buprenorphine to local anesthetics used for interscalene or axillary perivascular brachial plexus blocks. The main objective of the current study was to determine whether addition of buprenorphine could enhance bupivacaine analgesia after infragluteal sciatic nerve block.
METHODS: One hundred and three consenting adult patients for elective foot and ankle outpatient surgeries were prospectively assigned randomly, in double-blind fashion, to one of three groups. Group 1 received 0.5% bupivacaine with epinephrine 1:200,000 for infragluteal sciatic block plus 1 ml normal saline intramuscularly. Group 2 received bupivacaine sciatic block along with intramuscular buprenorphine (0.3 mg). Group 3 received bupivacaine plus buprenorphine for infragluteal sciatic block and 1 ml normal saline intramuscularly.
RESULTS: Although patients receiving buprenorphine either for sciatic block or intramuscularly had less pain in the postanesthesia care unit compared with patients receiving only bupivacaine, the individual pair-wise comparison of the analysis of variance model showed no statistical difference. However, only buprenorphine added to bupivacaine for sciatic block prolonged postoperative analgesia. Patients receiving a combination of buprenorphine and bupivacaine for sciatic block had lower numeric rating pain scores and received less opioid medication at home than patients in the other two groups.
CONCLUSIONS: The results show that buprenorphine may enhance and prolong the analgesic effect of bupivacaine when used for sciatic nerve blocks in patients undergoing foot and ankle surgery under general anesthesia but does not do so to the extent shown in previous studies using brachial plexus models with mepivacaine and tetracaine.
Authors:
Kenneth D Candido; Jason Hennes; Sergio Gonzalez; Marianne Mikat-Stevens; Michael Pinzur; Vladimir Vasic; Nebojsa Nick Knezevic
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Anesthesiology     Volume:  113     ISSN:  1528-1175     ISO Abbreviation:  Anesthesiology     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2010-12-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1419-26     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, Illinois 60657, USA. kdcandido@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Ambulatory Surgical Procedures
Analgesics, Opioid / administration & dosage,  therapeutic use*
Anesthetics, Local*
Ankle / surgery
Bupivacaine*
Buprenorphine / administration & dosage,  therapeutic use*
Double-Blind Method
Female
Foot / surgery
Humans
Injections, Intramuscular
Male
Middle Aged
Nerve Block*
Orthopedic Procedures
Pain Measurement
Pain, Postoperative / drug therapy*
Patient Satisfaction
Postoperative Nausea and Vomiting / epidemiology
Preanesthetic Medication
Sciatic Nerve*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 0/Anesthetics, Local; 2180-92-9/Bupivacaine; 52485-79-7/Buprenorphine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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