Buprenorphine added to levobupivacaine enhances postoperative analgesia of middle interscalene brachial plexus block
Journal of Anesthesia, 06/12/2012
Behr A et al. – Epineural buprenorphine prolonged postoperative analgesia of middle interscalene brachial plexus block (MIB) more effectively than intramuscular buprenorphine, which suggests that buprenorphine acts at a peripheral nervous system site of action.Methods
- One hundred and fifty consenting adult patients, scheduled for shoulder arthroscopic surgery for a rotator cuff tear under MIB with 29.5ml of 0.75 % levobupivacaine, were randomized to receive additionally either saline or intramuscular buprenorphine 0.15mg or epineural buprenorphine 0.15mg.
- Onset of sensory and motor blocks, duration of postoperative analgesia, and consumption of postoperative analgesics were compared among the groups.
- There were significant (P<0.05) differences in the onset and the duration of the sensory block and in the duration of postoperative analgesia.
- Duration of both sensory block and postoperative analgesia was longer (P<0.05) in patients who had received epineural buprenorphine (856.1±215.2 and 1,049.7±242.2min) than in patients who had received intramuscular buprenorphine (693.6±143.4 and 820.3±335.3min) or saline (488.3±137.6 and 637.5±72.1min).
- Requirement of postoperative rescue analgesics was lower in the epineural buprenorphine group than in the other two groups.
- Few complications occurred from MIB (<1%) and none from buprenorphine.