buprenorphine and Hernia--Inguinal

The transversus abdominis plane (TAP) block is an effective technique to block the thoracolumbar nerves innervating the anterolateral abdominal wall. This study was conducted to evaluate the analgesic efficacy and opioid consumption with the use of perineural buprenorphine or dexamethasone in TAP blocks after unilateral inguinal hernioplasties.. This prospective, randomized, double-blinded, placebo-controlled study enrolled 93 patients scheduled for unilateral inguinal hernioplasty, followed by an ultrasound-guided TAP block. The participants were randomized into 3 groups (31 patients each). Group L received 20 ml 0.25% levobupivacaine + 1 ml normal saline (NS); group LB, 20 ml 0.25% levobupivacaine + 0.3 mg (1 ml) buprenorphine; and group LD, 20 ml 0.25% levobupivacaine + 4 mg (1 ml) dexamethasone. The patients were observed postoperatively for 24 h for first rescue analgesic requirement, total rescue analgesic consumption, and pain scores on the numeric rating scale (NRS).. The time to first rescue analgesic requirement was significantly longer in Group LB than in groups LD and L (688.87 ± 36.11 min, 601.45 ± 39.85 min, and 383.06 ± 36.21 min, respectively; P < 0.001). The mean total tramadol consumption in the first 24 h was the lowest in group LB (P < 0.001, L vs. LB / LD). Groups LB and LD displayed significantly lower NRS scores than group L (P < 0.001 both).. Levobupivacaine with perineural buprenorphine in a TAP block after unilateral open inguinal hernioplasty facilitates prolonged analgesia and reduced requirement for rescue analgesics compared to perineural dexamethasone, without significant side effects.

Topics: Abdominal Wall; Adult; Aged; Analgesics, Opioid; Anesthetics, Local; Buprenorphine; Dexamethasone; Double-Blind Method; Female; Hernia, Inguinal; Herniorrhaphy; Humans; Levobupivacaine; Male; Middle Aged; Nerve Block; Pain Measurement; Pain, Postoperative; Prospective Studies; Ultrasonography, Interventional

We compared the effects of extradural with intravenous (i.v.) buprenorphine on postoperative pain and recovery characteristics.. Thirty patients, aged 11-13 years, who were undergoing inguinal hernia repair with or without orchidopexy, were randomly allocated to receive either caudal 0.5% bupivacaine alone (group A) or were additionally given i.v. buprenorphine 2.5 micro g.kg-1 (group B) or caudal buprenorphine in the same dose (group C). Patients were followed for 8 h after the end of surgery.. All patients remained haemodynamically stable during the study period and no clinical respiratory depression was seen. Nausea, vomiting, urinary retention and pruritus were more common in the extradural buprenorphine group. Three patients in group A, five in group B and eight in group C did not require any additional analgesia during the study period. The incidence of vomiting was 20%, 50% and 80% in groups A, B and C, respectively. Four patients in group C had urinary retention compared with one each in the other two groups.. Administration of buprenorphine resulted in a higher incidence of side-effects.

Topics: Adolescent; Analgesics, Opioid; Anesthesia Recovery Period; Anesthetics, Local; Bupivacaine; Buprenorphine; Child; Cryptorchidism; Hernia, Inguinal; Humans; Injections, Epidural; Injections, Intravenous; Male; Pain, Postoperative; Postoperative Nausea and Vomiting