Abstract :
Introduction: Epidural opioid when combined with general anaesthesia (GA) for laparoscopy assisted vaginal hysterectomies (LAVH) effectively attenuates stress response caused by carbon dioxide (CO2) pneumoperitoneum. Moreover epidural opioids provide effective pain relief in the post-operative period.
Objectives: To compare intra-operative hemodynamics and post-operative pain relief between epidural morphine and epidural buprenorphine when combined with GA for LAVH.
Methods: 40 patients posted for LAVH under American Society of Anaesthesiologists (ASA) physical classification I and II were randomly allocated into two groups. Group M received 3mg morphine and Group B received 0.15mg buprenorphine with 14ml of 0.25% bupivacaine in epidural route before GA. Blood pressure and heart rate were recorded in all the patients before epidural injection, after induction of GA, after pneumoperitoneum along with trendelenburg position, every 10minutes after pneumoperitoneum and after desufflation and straightening the table. Duration of post-operative analgesia was recorded and injection tramadol in 50mg increments was used as rescue analgesia. Total tramadol consumption was also recorded in all the patients.
Results: There was a statistically significant decrease in heart rate and blood pressure over time in both the groups (p0.05). The duration of analgesia was significantly longer in Group M compared to Group B (p
Keyword :
Buprenorphine; Epidural; Hysterectomy; Laparoscopy; Morphine