A comparative study on the effect of addition of intrathecal buprenorphine to 2-chloroprocaine spinal anesthesia in short duration surgeries

Abstract

Background and Aims: Spinal anesthesia is a safe and reliable technique for surgeries on the lower abdomen and lower limbs. Some of its characteristics like delayed ambulation and pain after block regression may limit its use, especially for short duration surgeries. 2-chloroprocaine is an amino-ester local anesthetic with an approximate duration of action of 40 minutes, which is ideal for short duration surgeries. This study aims to compare the effect of adding intrathecal buprenorphine to 2-chloroprocaine with regard to spinal anesthesia characteristics. Material and Methods: After obtaining the institutional ethical committee clearance and clinical trial registration, informed consent was taken from 90 patients who were undergoing either lower abdominal or lower limb surgeries of less than 60 minutes duration and were then randomized into two groups. Group C received 40 mg of 1% 2-chloroprocaine and Group B received 40 mg of 1% 2-chloroprocaine with 60 mcg of buprenorphine. Sensory/motor block characteristics, first analgesic requirements, time to void, and unassisted ambulation were assessed. Student t test was used to analyze the metric parameters and Fisher's exact test was used to compare the categorical variables. Results: The time of onset of sensory and motor blocks, peak sensory block, readiness for surgery, and complete regression of both sensory and motor blocks were comparable between the groups. Group B showed significantly prolonged duration of postoperative analgesia (855.82 ± 667.09 vs. 359.07 ± 253.3 minutes). 91.1% patients were able to ambulate within 100 minutes in our study. Conclusion: We conclude that addition of buprenorphine to 2-chloroprocaine has a significant synergistic effect on prolonging postoperative analgesia.

Keywords

• 2-chloroprocaine
• accelerated ambulation
• buprenorphine
• postoperative pain
• spinal anesthesia