Bupivacaine Plus Research Articles

Comparison of Postoperative Analgesic Effectiveness of Bupivacaine and Bupivacaine Plus Dexmedetomidine Wound Infiltration in Abdominal Surgeries under General Anesthesia

Abdominal surgeries were major surgical procedures that were performed at any teaching hospital. Pain control was a major concern during intra-operative as well as post-operative periods in these patients. Objective: To compare post-operative analgesic effectiveness of bupivacaine and bupivacaine plus dexmedetomidine wound infiltration in abdominal surgeries under General Anesthesia. Methods: This randomized controlled trial was conducted at the Department of Anesthesia, Sahiwal Teaching Hospital Sahiwal from 1st April, 2024 till 31st May 2024. Sixty-four patients underwent a pre-operative assessment on the day before surgery. Both Groups received wound infiltration with studied drugs at the end of surgery. After surgery, patients were assessed for pain using a Visual Analog Scale (VAS) and data was collected and analyzed using Statistical Package for the Social Sciences (SPSS) version 26.0. Results: The mean post-operative analgesia duration of the patients on bupivacaine was 11.78 ± 1.64 but the mean post-operative analgesia duration of the patient on bupivacaine plus dexmedetomidine was 19.19 ± 2.49. (2-tailed significance 0.001). The mean opioid consumption in mg of the patients in bupivacaine was 20.69 ± 4.31 but the mean opioid consumption in mg of the patient in bupivacaine plus dexmedetomidine was 10.88 ± 4.53. (2-tailed significance 0.001). In bupivacaine, patients with bradycardia were 0% and patients without bradycardia were 100% but in bupivacaine plus dexmedetomidine, patients with bradycardia were 15.6% and patients without bradycardia were 84.4%. Conclusions: There was a difference in the analgesic effectiveness of dexmedetomidine when added to bupivacaine in wound infiltration in abdominal surgeries.

The Effect of Intrathecal Bupivacaine Plus Dextrose 5% and Fentanyl Compared with Bupivacaine Alone on the Onset and Duration of Analgesia in Patients Undergoing Lower-Limb Orthopedic Surgery.

This study aimed to compare the effect of intrathecal bupivacaine plus dextrose 5% and fentanyl with bupivacaine alone on the onset and duration of analgesia in patients undergoing lower-limb orthopedic surgery. A total of 40 patients eligible for lower-limb surgery were divided into two groups by simple randomization: the control group which received only bupivacaine and the intervention group which received bupivacaine plus dextrose 5% and fentanyl. Anesthesia was induced by the spinal method. The visual analog scale (VAS) was used to assess the patients' pain; hemodynamic status (systolic and diastolic blood pressure and the heart rate) and oxygen saturation were also monitored. There was a significant difference between groups in the type of lower-limb movement at the L1 anesthesia level, the sensory block level at time zero after surgery, the type of backward movement at time zero after surgery, and the analgesic dose received (p < 0.05). Fifteen and 30 minutes after the start of surgery, mean systolic blood pressure, and 45 and 60 minutes after the start of surgery, systolic and diastolic blood pressure and the heart rate were significantly lower in the control group than in the intervention group (p < 0.05). The VAS score was significantly lower in the intervention group than in the control group at 6 and 24 hours after surgery (p < 0.05). Systolic and diastolic blood pressure at time zero, systolic blood pressure at hour 6, and diastolic blood pressure at hour 24 after surgery were significantly lower in the control group than in the intervention group (p < 0.05). The mean duration of anesthesia and analgesia was significantly longer in patients receiving bupivacaine plus fentanyl than in those receiving bupivacaine alone. However, concerning hemodynamic parameters, it cannot be concluded that the bupivacaine plus fentanyl receiving group was generally superior to the bupivacaine receiving group.

A comparative study of intrathecal dexmedetomidine, fentanyl and magnesium sulphate as adjuvants to 0.5% hyperbaric bupivacaine for lower abdominal surgeries

Goal & Background: This research was aimed at comparing the effect, onset and duration of sensory and motor block, hemodynamic effects, analgesic effects and the adverse effects of intrathecal dexmedetomidine, fentanyl and magnesium sulphate to 0.5% hyperbaric bupivacain. Methods: the research is done on 60 ASA I or II patients aged 18 to 60 years planned for the lower abdominal procedure under a spinal anaesthetic, randomly assigned to four equal groups (25 patients each) by means of a computer generated random number table: Group I: 15 mg of 0.5 percent intrathecally hyperbolic bupivacaine +0.5 ml of normal saline received. Group II: 15 mg 0.5% hyperbaric + 50 mg MgSO4 intrathecally received. Group III: 15mg hyperbaric bupivacaine Plus 25μg intrathecally of fentanyl. Group IV: receives 15 mg of 0.5 percent hyperbaric bupivacaine and 5 μg of diluted intrathecally dexmedetomidine. Results and Conclusion: Magnesium sulphate has a speedier start, although both fentanyl and dexmedetomidine have a longer duration and an enhanced block power. As a local anaesthetic addition, magnesium and dexmedetomidine may have fewer side effect than fentanyl. Intrathacal injection with bupivacaine of dexmedetomidine and MgSO4 was beneficial in lowering the occurrence of post-SA tearing. We are thus encouraging the use of MgSO4 since it is more physiologically available, more accessible and considerably cheaper than dexmedetomidine in most operating theatres. Magnesium offers hemodynamic stability, with less side effects than fentanyl.

Effects of Intrathecal Bupivacaine and Bupivacaine Plus Fentanyl in Elderly Patients Undergoing Total Hip Arthroplasty.

To determine and compare the clinical efficacy of spinal anesthesia with bupivacaine combined with fentanyl and bupivacaine alone in geriatric patients scheduled for total hip arthroplasty (THA). Experimental study. Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China, from April 2016 to April 2017. Sixty-five geriatric patients were randomised into two groups. Group B was anesthetised with 0.5% bupivacaine 10 mg and Group F with 0.5% bupivacaine 7.5 mg plus fentanyl 20 μg. Hemodynamic stability, effect and satisfaction of anesthesia, time to the first postoperative analgesic requirement, adverse effects, and incidence of postoperative indwelling catheter were compared. There was no significant difference in time to reach maximum sensory block level, maximum sensory block level, maximum motor block, duration of motor block, quality of anesthesia, adverse effects or the incidence of postoperative indwelling catheter between the two groups. However, Group F required less dosage of ephedrine for stable hemodynamics and longer time to use the primary postoperative analgesic in comparison to Group B (p<0.05). Adding 20 μg fentanyl to a lower dose of 7.5 mg bupivacaine can provide safe and effective spinal anesthesia for THA in geriatric patients.

Postoperative Epidural Analgesia between 0.25% Ropivacaine Plus Tramadol and 0.25% Bupivacaine Plus Tramadol in Abdominal and Lower Limb Surgeries - A Comparative Study

Postoperative Epidural Analgesia between 0.25% Ropivacaine Plus Tramadol and 0.25% Bupivacaine Plus Tramadol in Abdominal and Lower Limb Surgeries - A Comparative Study

Comparison of the Effect of Bupivacaine in Combination with Dexmedetomidine with Bupivacaine Plus Placebo on Neonatal Apgar Score, Bispectral Index, and Sedation Level of Parturient Women.

ObjectivesIn this study, we aimed to compare the effects of bupivacaine alone and in combination with dexmedetomidine on postoperative analgesia, neonatal Apgar score, and bispectral index (BIS), which has been shown to correlate with increased sedation and loss of consciousness in women undergoing cesarean section under spinal anesthesia.MethodsA total of 152 term parturient women scheduled to have elective cesarean section with American Society of Anesthesiologist (ASA) physical status I or II were allocated randomly into two groups to receive either bupivacaine plus placebo (BV group) or bupivacaine plus dexmedetomidine (BVD group). BIS, sedation scale scores, Apgar scores, and hemodynamic characteristics were recorded and statistically compared between the groups.ResultsOnset of post-operative pain was delayed in the BVD group. Sedation score (Ramsay sedation section) was improved in the BVD group with the least values of 0 - 3 followed by 1 - 4. There was no significant difference in Apgar score between the two groups. Also, there was a significant distinction between the two groups in terms of BIS during cesarean section.ConclusionsThe use of intrathecal dexmedetomidine as an adjuvant to bupivacaine in cesarean surgeries provides better intra-operative and post-operative analgesia without any significant impact on Apgar scores or incidence of side effects.

The Effect of Different Doses of Intrathecal Hyperbaric Bupivacaine Plus Sufentanil in Spinal Anesthesia for Cesarean Sections

BackgroundDecreasing side effects and improving the quality of block in caesarean sections by appropriate dosage of local anesthetics and adjuvants could play an important role in the safe management of cesarean section. The present study aimed at comparing the effects of 3 different doses of intrathecal hyperbaric bupivacaine injected with a fixed dose of sufentanil in cesarean sections.MethodsIn a double- blind randomized clinical trial, 105 candidates of elective cesarean section were randomly assigned into 3 groups of 8, 9, and 10 mg of intrathecal bupivacaine plus sufentanil 2.5 µg. The maximum level of sensory block, the intensity of motor block, and vital signs were measured at regular intervals. The incidence of hypotension and bradycardia were also recorded.ResultsNo significant difference was found between the maximum level of sensory block and the intensity of motor block in 3 groups. The incidences of hypotension and bradycardia as well as administration of atropine and ephedrine were comparable among the 3 groups (P > 0.05).ConclusionsAccording to similar effects of different doses of bupivacaine, administration of lower doses of bupivacaine (8mg) is more reasonable for spinal anesthesia for cesarean section.

Letter to: "The Effect of Different Doses of Intrathecal Hyperbaric Bupivacaine Plus Sufentanil in Spinal Anesthesia for Cesarean Sections".

Letter to: "The Effect of Different Doses of Intrathecal Hyperbaric Bupivacaine Plus Sufentanil in Spinal Anesthesia for Cesarean Sections".

Comparative Study of Hernia Block with Bupivacaine Alone and Bupivacaine Plus Dexamethasone as Adjuvant for Open Hernia Repair at Day Care Unit

Comparative Study of Hernia Block with Bupivacaine Alone and Bupivacaine Plus Dexamethasone as Adjuvant for Open Hernia Repair at Day Care Unit

Effect of Intravenous Dexamethasone on Spinal Anaesthesia With Bupivacaine Plus Fentanyl in Patients Undergoing Vaginal Hysterectomy

Effect of Intravenous Dexamethasone on Spinal Anaesthesia With Bupivacaine Plus Fentanyl in Patients Undergoing Vaginal Hysterectomy

A Comparative Study of Post Operative Side Effects between Spinal Bupivacaine Plus Buprenorphine and Combined Femoral and Sciatic Nerve Block Plus Spinal Bupivacaine Used for Analgesia

A Comparative Study of Post Operative Side Effects between Spinal Bupivacaine Plus Buprenorphine and Combined Femoral and Sciatic Nerve Block Plus Spinal Bupivacaine Used for Analgesia

A Comparative Study of Post-Operative Side Effects between Spinal Bupivacaine Plus Buprenorphine and Combined Femoral and Sciatic Nerve Block Used For Analgesia

A Comparative Study of Post-Operative Side Effects between Spinal Bupivacaine Plus Buprenorphine and Combined Femoral and Sciatic Nerve Block Used For Analgesia

Comparison of the Maternal and Neonatal Effects of Intratechal Bupivacaine Plus Fentanyl or Morphine During Cesarean Delivery

Comparison of the Maternal and Neonatal Effects of Intratechal Bupivacaine Plus Fentanyl or Morphine During Cesarean Delivery

MP27-05 ROLE OF BUPRENORPHINE IN PROLONGING THE DURATION OF POSTOPERATIVE ANALGESIA IN PCNL: COMPARISON BETWEEN BUPIVACAINE AND BUPIVACAINE PLUS BUPRENORPHINE COMBINATION.

You have accessJournal of UrologyStone Disease: Therapy III1 Apr 2014MP27-05 ROLE OF BUPRENORPHINE IN PROLONGING THE DURATION OF POSTOPERATIVE ANALGESIA IN PCNL: COMPARISON BETWEEN BUPIVACAINE AND BUPIVACAINE PLUS BUPRENORPHINE COMBINATION. Pisapati Murthy, Nirmala Jonnavithula, Srinivas Mantha, Anil Ch, Rahul Devraj, and Vidyasagar Sriramoju Pisapati MurthyPisapati Murthy More articles by this author , Nirmala JonnavithulaNirmala Jonnavithula More articles by this author , Srinivas ManthaSrinivas Mantha More articles by this author , Anil ChAnil Ch More articles by this author , Rahul DevrajRahul Devraj More articles by this author , and Vidyasagar SriramojuVidyasagar Sriramoju More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.368AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Percutaneous nephrolithotomy (PCNL) is the treatment of choice for large renal calculi. Usually a nephrostomy tube is placed at the end of the procedure for drainage and removal of residual calculi. The pain around the nephrostomy tube may be distressing requiring analgesics. Peritubal infiltration of nephrostomy tract with bupivacaine for postoperative pain lasted for 14hrs only. We hypothesize that addition of buprenorphine, a semisynthetic opiod to local anesthetic may prolong the duration of analgesia. Objective: To investigate the role of buprenorphine and bupivacaine combination in prolonging the duration of analgesia in peritubal infiltration following PCNL. METHODS A prospective randomized controlled study was undertaken in 40 ASA grade I and II patients after Institutional ethics committee approval and informed consent from the patients. All patients received standard general anesthesia and a nephrostomy tube 16 F was placed at the end of the procedure. Group I pts received 20ml of 0.25% bupivacaine and group II received 20ml of 0.25% bupivacaine with 100μgm of buprenorphine. Peritubal infiltration was given under fluoroscopic guidance with 23G Spinal needle at 6 and 12 0’ clock positions along the nephrostomy tube from renal capsule to the skin infiltrating all layers including renal capsule, muscles, subcutaneous tissue and skin. Postoperative pain was assessed by VAS and Dynamic VAS (pain on deep breath and cough -D VAS),sedation score, duration of analgesia, number of rescue analgesic demands by an independent observer blinded to the study, every 4 hours till 24hrs. Rescue analgesia was inj tramadol 1mg/kg IV if pain score exceeds 4. RESULTS Statistical analysis was done using Minitab -14. Demographic data was comparable between the groups. Median duration of analgesia was 16hrs [IQR 12-16] in G I and in G II it was 20hrs [16-24] with p-0.002. Maximum median VAS was 4 {4-4] in G I and 2 [ 2-4] in G II ( p-0.002). The median time to attain maximum VAS was 5hrs [5-6.5] in G I and 7 [5-7] in G II (p-0.061). The median AUC for VAS was 7 [6-9] hrs in G I and 5 [3-7] (p-0.047). The median maximum DVAS in GI was 6[5.5-6] and 4 [2-6] hrs in G II, The median time to achieve maximum DVAS was 5hrs[4-5.5] in GI and 7 [5-7 ]in GII (p-0.007). The median AUC for DVAS in 24hrs was 16 [15-17] hrs in G I and 15 [12-16] hrs in G II (p-0.017). CONCLUSIONS Peritubal infiltration of 0.25% bupivacaine with 100μgm buprenorphine has significantly increased the duration of analgesia without any side effects. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e276 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Pisapati Murthy More articles by this author Nirmala Jonnavithula More articles by this author Srinivas Mantha More articles by this author Anil Ch More articles by this author Rahul Devraj More articles by this author Vidyasagar Sriramoju More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Effects of Local Anesthesia With Bupivacaine Plus Epinephrine on Blepharoptosis and Levator Palpebrae Muscle Function

To evaluate the effect of local anesthesia with bupivacaine plus epinephrine on the extent of blepharoptosis and levator palpebrae muscle function. : In this prospective interventional case series, patients with blepharoptosis who were candidates for aponeurotic surgery were included. After initial preparations in the operating room, a total of 1 ml of a mixture of bupivacaine 0.5% plus epinephrine 1:100,000 were injected into the upper eyelid. The margin reflex distance 1 (MRD1) and the extent of levator muscle function were measured before and 2, 5, 10, and 15 minutes after injection. A total of 36 eyes including 21 men (58.3%) and 15 women (41.7%) with an average age of 41.81 ± 23.09 (17-83 years) were studied. There were 21 eyes with myogenic and 15 eyes with aponeurotic blepharoptosis. The mean MRD1 was 1.18 ± 1.06 mm before injection and -0.02 ± 0.85, 0.52 ± 0.98, 0.98 ± 1.05, and 1.02 ± 1.06 mm at 2, 5, 10, and 15 minutes after injections, respectively. The changes in the MRD1 measurements were statistically significant at all time points. The MRD1 values decreased during the first 2 minutes after injection in 88.8% of eyes, but returned to initial value after 15 minutes in 84.3%. The change in the levator muscle function measurements was statistically significant at 2 and 5 minutes after injections; however, the differences were clinically negligible. : The local anesthesia of the eyelid with 1 ml bupivacaine plus epinephrine causes a temporary increase of blepharoptosis within the first few minutes with minimal effect on levator muscle function measurements.

The Effect of Intrathecal Bupivacaine Plus Sufentanil on Intraoperative Hemodynamics During Elective Coronary Artery Bypass Surgery

Introduction: Intrathecal opioids have been used for many patients undergoing surgical operations to improve clinical outcomes. Cardiopulmonary bypass in patients undergoing coronary artery bypass graft surgery carries a number of drawbacks, namely hemodynamic derangements. Several methods have been used to suppress this state; among them is sympathetic blockade by neuraxial anesthesia. This study assesses the effect of intrathecal adjuvant bupivacaine plus sufentanil on intraoperative hemodynamic changes in elective coronary artery bypass surgery. Methods: In a double-blind, randomized, placebo-controlled clinical trials, 80 patients scheduled for elective CABG were randomly assigned into 2 groups. One group received intrathecal sufentanil (S) and the other group received the same dose of sufentanil plus supplemental bupivacaine (SB). All the patients were similar regarding other items. Hemodynamic and clinical outcomes including blood pressure values were measured during and after the operation. Results: There were more stable hemodynamic parameters in the SB group. Also, the SB group patients were extubated sooner than the other patient group. Discussion: The administration of intrathecal sufentanil plus bupivacaine seems to keep the hemodynamic status of the patients more stable than intrathecal sufentanil alone.

Is It Justified to Inject IV Bupivacaine Plus Epinephrine in Children to Determine Its Reliability as a Test Dose?

To the Editor For several reasons, we question the appropriateness of injecting 0.25% bupivacaine with epinephrine (1:200,000) in children as part of a study to determine its reliability to indicate inadvertent intravascular injection.1 First, Polaner et al. injected 0.1 mL/kg 0.25% bupivacaine (maximum 3 mL) with 1:200,000 epinephrine and, based on an estimated blood volume of 2 to 2.5 L in a 30-kg child, a concentration approaching the cardiotoxic level of 3 to 4 μg/mL could be reached. Second, intravascular 0.125% bupivacaine (0.2–0.4 mL/kg) with 1:200,000 epinephrine has been shown to be more effective in demonstrating an increase in heart rate and T wave amplitude as compared with 0.125% bupivacaine alone in neonatal piglets under sevoflurane anesthesia.2 Similar hemodynamic changes were demonstrated with 0.5 μg/kg epinephrine in combination with lidocaine or bupivacaine in children receiving sevoflurane anesthesia.3,4 In other words, it is likely that the epinephrine alone rather than the local anesthetic is responsible for the hemodynamic changes observed after intravascular injection and, if applied to this study, could have spared these children anesthetized with propofol-remifentanil the IV injection of a potentially dangerous dose of bupivacaine. Third, the depth of anesthesia was not tested and it is possible that the variability of response is a function of anesthetic depth. In view of the above, we wonder if exposing children as young as 8 months to intravascular bupivacaine is justified. Anjolie Chhabra, MBBS, MD, DNB Gautham Ganesan, MBBS Department of Anesthesiology and Intensive Care All India Institute of Medical Sciences Ansari Nagar New Delhi, India [email protected]

Continuous Epidural Infusion of 0.05% Bupivacaine Plus Hydromorphone for Labor Analgesia: An Observational Assessment in 1,830 Parturients

Continuous Epidural Infusion of 0.05% Bupivacaine Plus Hydromorphone for Labor Analgesia: An Observational Assessment in 1,830 Parturients

Continuous Epidural Infusion of 0.05% Bupivacaine Plus Hydromorphone for Labor Analgesia: An Observational Assessment in 1830 Parturients

We evaluated a continuous epidural infusion containing bupivacaine 0.05% plus the opioid hydromorphone in 1830 women requesting pain relief during labor and delivery. The infusion provided effective analgesia with minimal adverse events for patients differing in parity and at varying stages of labor. Pain relief was maintained in most patients without the need for epidural reinforcement with more concentrated doses of local anesthetic.