Comparison of Mean Duration of Postoperative Analgesia in Patients Undergoing Cesarean Section Under Spinal Anesthesia with Bupivacaine Vs. Bupivacaine Plus Buprenorphine

Abstract

Objective: To compare the effect of intrathecal bupivacaine alone vs intrathecal buprenorphine as an adjuvant to bupivacaine on postoperative analgesia in cesarean section patients receiving spinal anesthesia.
Study Design: The Quasi experimental study.
Place and Duration of Study: “Department of Anesthesia”, Lahore General Hospital, Lahore, from 1st May 2022 to 29th May 2023.
Materials and Methods: Sixty pregnant women (ASA I-II, aged between 20-35 years) scheduled for elective cesarean section were enrolled through non-probability consecutive sampling. “Group B” received 1.8ml of 0.5 % hyperbaric bupivacaine with 0.5ml normal saline, while “Group BB” was administered 1.8ml of 0.5% hyperbaric bupivacaine combined with 60μg buprenorphine. All participants were informed of study objectives and provided written consent. Postoperative pain was evaluated using the visual analog scale (VAS). The duration of analgesia, total rescue analgesic use, onset of sensory block, and adverse effects were recorded 24 h after surgery.
Results: Group BB showed significant longer duration of postoperative analgesia and reduced need for rescue analgesics. Maximum VAS scores were also significantly lower in Group BB, with 73.3% of patients reporting a score of 4. Mild sedation (16.7%) and nausea/vomiting (10%) were noted in Group BB, but no respiratory depression was observed. All neonates had Apgar scores > 7 at 1 and 5 minutes.
Conclusion: Intrathecal buprenorphine combined with bupivacaine in cesarean section significantly improves pain control and prolongs the analgesic effect. Given its favorable benefit-risk profile, it can be considered a safe and effective adjunct to spinal anesthesia.