ABSTRACT:
Background and Objective: Instillation of opioids as an adjuvant to local anesthetics continues to be the gold standard for postoperative analgesia in cesarean section but they do have some disturbing side effects. This study aimed to evaluate the safety and efficacy of buprenorphine (45ug) as an adjuvant to hyperbaric bupivacaine for postoperative analgesia in the lower segment cesarean section. The primary objective was to compare postoperative analgesia in two groups with respect to the onset and duration of analgesia and the secondary objective was to compare the incidence of side effects in the two groups with respect to the mother and fetus. Materials and methods: This prospective randomized double-blind study involved 60 parturients posted for elective cesarean section under subarachnoid block. Group A received 2ml (10mg) of 0.5% hyperbaric bupivacaine with 45ug buprenorphine and Group B received 2ml (10mg) of 0.5% hyperbaric bupivacaine with 1.5ml normal saline. The following parameters were observed: onset and duration of motor block, the onset of sensory block, duration of analgesia, rescue analgesic requirement and neonatal side effects if any. Statistical analysis: Data was analyzed using SPSS version 17.0 for Windows. Student’s ‘t’ test was used to test the significance of the difference between quantitative variables and Chi-square test for qualitative variables. A ‘p’ value less than 0.05 was considered to be significant. Results: The duration of analgesia was significantly longer in the buprenorphine group (795.33 ± 261.49 minutes) as compared to the control group (294 ± 76.13 minutes). The number of rescue analgesic doses required by the parturients and pain score was significantly low in the study group. The incidence of side effects was low in both groups. Conclusion: The present study thus proves that low dose buprenorphine (45µg), when added to bupivacaine, provides prolonged analgesia in the cesarean section without significant maternal and neonatal side effects.