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2001, Number 2

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Rev Mex Anest 2001; 24 (2)

Buprenorfina epidural vs. Bupivacaína al 0.125% para el manejo del dolor en el paciente Post-operada de cesárea

Rojas JRA, Mendoza HME, Gutiérrez SE, Velasco PS, Murguía FY

Language: Spanish
References: 20
Page:
PDF size: 39.33 Kb.


ABSTRACT

Objetives: To evaluate the effectiveness of the postoperative analgesia with buprenorphine for elective Caesarean section. Material and methods: We carried out a traverse prospective and comparative study in 40 patients with pregnancy to term, with unique product, cephalic presentation, ASA I-II, with diagnosis of cefalopelvic disproportion, programmed for Caesarean section, with 20-35 year-old, weight of 60 to 80 kg. The blockade level was L2-L3 for postoperative analgesia. 2 groups of 20 patients were studied; the group I received bupivacaíne to 0.125% to 0.15 ml/kg in physiologic solution for a total of 12 ml. dose average of 10 mg. Group II received buprenorphine 3 mcg/kg more bupivacaíne 0.125% to 0.15 ml/kg dose average 10 mg., in physiologic solution for a total volume of 12 ml.
The pain was valued with the similar visual scale (EVA), meansurement of pain before and after. The EVA was interpreted as follows:
0–3 no pain or light pain
4–6 moderate pain.
7–10 severe pain
After buprenorphine administration FC, FR, T/A, analgesia and secondary effects as drowsiness, vomit, sedation. Results: We evaluated bupivacaíne combination with buprenorphine and obtained a better pain control in the postoperative period (p. ‹ 0.05) with duration of the analgesic effect of 6 to 7 hrs. without significant changes in blood pressure (p. = 0.08), and obtaining significance for respiratoty rate (p. ‹ 0.05).


REFERENCES

  1. Gibbs Charles P. Obstetric Anaesthesia: A national survey. Anesthesiology 1986;76:298-306.

  2. James Francis M. A. Comparation of general anesthesia and lumbar epidural analgesia for elective cesarean section. Anesthesia and Analgesia 1977;56:228-235.

  3. Evans C.M. Epidural versus general anaesthesia for elective cesarean section: effect on aspar score and acid-base status of the newborn. Anesthesia 1989;44:778-782.

  4. Vasconcelos P. G. La anestesia y la analgesia en la embarazada sana. Aldrette J. A. Anestesiología teórico-práctico. Salvat Mexicana. Tomo II 1990: 941-956.

  5. González Barrera, Cuenca Dardon J: Analgesia epidural postoperatoria comparando Buprenorfina-Fentanyl. Rev. Méx. Anest. 1996;19:10-15.

  6. Coushing M. J. Intratecal and epidural administration of opiods. Anesthesiology 1984;61:276-310.

  7. De Castro J, Rondomaska. The use of epidural buprenorphine the treatment of posoperative pain. Anaesthesiology 1982;144:91-94.

  8. Preys Roberts C, Hus Reeves. Farmacocinética y dinámica de los analgésicos narc óticos, ed. Manual Moderno. México., D.F 1986: 163-208.

  9. Stoelting R.K: Opioid agonist and antagonist pharmacology and physiology in anesthesic practice. J.B Lipincott. Chapter 3; 1987: 65-69, 148-168.

  10. Duthie DJR, Nimo WS. Adverse effects of opioid analgesic drugs. Br J Anaesth, 1987;59:61-77.

  11. Boas RA, Village JW: Clinical actions of Fentanyl and buprenorphine. The significance of the receptorbindings. Br J Anaesth, 1985;57:192-196.

  12. Downins J, Wileary WP. Buprenorphine: a new potent long-acting synthetic analgesic. Comparison with morphine. Anesthesiology 1985;66:240-244.

  13. J. Wolff, MD P, Carl MD. Epidural buprenorphine for postoperative analgesia. A controlled comparison with epidural morphine. Anaesthesia 1986 Jan;41 (1) 76-79.

  14. Yoshimi Inagaki, MD, Takashi Mashimo MD: Mode and site of analgesic action of epidural buprenorphine in humans. Anesth Analg 1996;83:530-536.

  15. Shavl Cohen MD, Daud. AMG, MD. Advers effects of epidural 0.03% bupivacaine during analgesia after cesarean section. Anesth Analg 1992; 75: 753-756.

  16. Gibbs C. P. Obstetric Anesthesia: A national survey. Anaesthesiology, 1986;76:298-307.

  17. Wulf H. W. Parmacokinetics and protein binding of bupivacaine in postoperative epidural analgesia. Acta Anaesthesiol Scand 1988; 32:530-534.

  18. P. G. Barash et al: Clinical anesthesia 3 ra edición Lippincott 2000; pp 1305-1307.

  19. R. D. Miller. Anesthesia. Fifth edition, volumen 1 2000 : 346-347.

  20. Pleuvry B.J : Opiod receptors and Their ligands: natural an unnatural Br. J. Anaesth. 1991; 66: 370-380.




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