buprenorphine and Muscle-Weakness

The purpose of the study was to compare the analgesic and side effects of two epidurally administered mixtures of bupivacaine and fentanyl with the same drug ratios.. One hundred patients scheduled for colorectal surgery were randomized to receive a thoracic epidural infusion of either bupivacaine 0.12% with fentanyl 2 micrograms/ml or bupivacaine 0.24% with fentanyl 4 micrograms/ml during 48 h postoperatively. The pumps were adjusted to keep the visual analogue scale (VAS) pain score at 3 or less (on a scale of 0-10) with a minimum of adverse effects.. There were no statistically significantly differences between the two groups in VAS pain scores. The average VAS pain score resting varied between 0.5 and 1, and coughing between 1.9 and 3.4. One case of respiratory depression with breathing frequency 7 occurred in each group, but none of the patients required naloxone. One patient in the low concentration group developed partial motor weakness in both legs 36 h postoperatively. Equal drug amounts--bupivacaine 10.8-11 mg/h and fentanyl 18-18.4 micrograms/h--were given in both groups throughout the study.. Both groups had low pain scores with few and comparable adverse effects. It thus seems that the volume is not important when mixtures of bupivacaine and fentanyl in the studies concentrations are infused epidurally at a low thoracic level. Practical reasons favour the higher concentration mixture.

Topics: Aged; Analgesia, Epidural; Analgesics, Opioid; Anesthetics, Local; Bupivacaine; Buprenorphine; Colon; Cough; Fentanyl; Follow-Up Studies; Humans; Infusion Pumps; Injections, Intravenous; Leg; Middle Aged; Muscle Weakness; Naloxone; Narcotic Antagonists; Pain Measurement; Pain, Postoperative; Rectum; Respiration

In this study, we sought to determine the effect of intrathecal (IT) pentazocine or buprenorphine on the neurological outcome after a short interval of spinal cord ischemia in rats. Although IT morphine (30 microg) induced spastic paraparesis after 6 min of aortic occlusion, neither pentazocine (150 microg) nor buprenorphine (4 microg) produced neurological dysfunction. Our results indicate that the effect of various opioids on the motor function after a noninjurious interval of spinal cord ischemia is opioid-specific.

Topics: Analgesics, Opioid; Animals; Blood Pressure; Body Temperature; Buprenorphine; Injections, Spinal; Male; Morphine; Muscle Weakness; Paraparesis; Pentazocine; Rats; Rats, Sprague-Dawley; Reperfusion Injury; Spinal Cord Ischemia