Ghulam Nabi Memon, Fareeda Wagan, Razia Bahadur Khero, Rubina Ad Memon, Shams Raza Brohi, Malheer Muhmmad.
Testing the efficacy of lumbar epidural block and duration of analgesia with buprenorphine and bupivacaine, through lumbar epidural catheter for surgery on abdomen and lower limbs.
Med Channel Jan ;14(1):32-5.

OBJECTIVE: Of this study is to test the efficacy and duration of analgesia with 75 micro grams buprenorphine and bupivacaine 15 ml 0.5%, through lumbar epidural catheter for surgery of abdomen and lower limbs. DESIGN: Non randomized clinical trial. SETTING: This study was conducted in the department of anesthesia & intensive care unit at Nawabshah Medical College Hospital Nawabshah, during January 2006 to October 2006. PATIENTS AND METHIDS: 100 patients of either sex of ASA 1 &11, for surgery of abdomen and lower limbs were selected to test the efficacy of lumbar epidural block and duration of analgesia with buprenorphine 75 micrograms and bupivacaine 15 ml (0.5%) through lumbar epidural catheter Lumbar epidurals with catheter were established for intraoperative analgesia. The efficacy of the block was tested during surgery and the effect of analgesia was tested in postoperative period at 6, 12, 18, 24, 27, 30, 33, 36 and 40 hours and onwards by mostly Prince Henry Pain Scale and with verbal rating scale and visual analogue scale. RESULTS: 100 patients were included in study, the results revealed excellent early intraoperative and long postoperative analgesia, with no side effects. Hemodynamic variables remained stable throughout surgical procedure. The patients remained comfortable and pain free during and after surgery up to 32.47 hours (mean time). The patients were able to ambulate earlier and were able to eat and drink in early period where feasible. In two cases, there was no effect of block. In another case we were unable to inject the drug due to kinking of catheter, In other five cases catheter penetrated the dura mater at the time of insertion and the technique was converted to spinal analgesia. Of the 100 patients, eight cases failed due to failure of epidural technique. 92 cases were successful. CONCLUSION: With this study, we conclude that lumbar epidural analgesia is best option for surgery on abdomen and lower limbs, and buprenorphine 75 microgram should be added to every epidural to improve quality and to increase the duration of analgesia.

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