Intrathecal fentanyl with 0.5% bupivacaine heavy in chronic opium abusers

Authors

  • Shikha Gupta Dayanand Medical College & Hospital, Ludhiana 141 001 Punjab INDIA
  • Kapil Dev Dayanand Medical College & Hospital, Ludhiana 141 001 Punjab INDIA
  • Sunil Katyal Dayanand Medical College & Hospital, Ludhiana 141 001 Punjab INDIA
  • Suneet Kathuria Dayanand Medical College & Hospital, Ludhiana 141 001 Punjab INDIA

Keywords:

Intrathecal, Fentanyl, Bupivacaine, Chronic Opium Abusers

Abstract

Background: Chronic use of opioids in opium abusers can cause poor pain control and increased analgaesic requirement. We compared the duration of spinal anaesthesia in chronic opium abusers and non-abusers. Method: This prospective randomised study included 60 American Society of Anesthesiologists (ASA) Grade I or II adults undergoing surgery under spinal anaesthesia with 10 mg bupivacaine, and 25 μg fentanyl in non-opium abusers (Group A); and chronic opium abusers (Group B), and 40 μg fentanyl in chronic opium abusers (Group C). Patients were assessed for onset and duration of sensory and motor blockade and duration of effective analgesia. Results: Mean time to onset of adequate analgesia in opium abusers was significantly longer in chronic opium abusers than in opium-naive patients. The duration of sensory block and motor block was significantly less in chronic opium abusers than in non-opium abusers. Duration of effective analgesia in groups A, B and C was 255.55 ± 26.84, 217.85 ± 15.15, and 268.20 ± 18.25 minutes, respectively; this difference was statistically significant. Conclusion: In chronic opium abusers, the duration of spinal anaesthesia is significantly shorter than that in opium nonabusers. The duration of spinal anaesthesia with bupivacaine and fentanyl in chronic opium abusers can be improved by increasing the intrathecal fentanyl dose from 25 μg to 40 μg.

Author Biographies

Shikha Gupta, Dayanand Medical College & Hospital, Ludhiana 141 001 Punjab INDIA

MD Associate Professor Department of Anaesthesia Dayanand Medical College & Hospital LUDHIANA 141 001 Punjab INDIA

Kapil Dev, Dayanand Medical College & Hospital, Ludhiana 141 001 Punjab INDIA

MD Ex-Registrar Department of Anaesthesia Dayanand Medical College & Hospital LUDHIANA 141 001 Punjab INDIA

Sunil Katyal, Dayanand Medical College & Hospital, Ludhiana 141 001 Punjab INDIA

MD Professor & Head Department of Anaesthesia Dayanand Medical College & Hospital LUDHIANA 141 001 Punjab INDIA

Suneet Kathuria, Dayanand Medical College & Hospital, Ludhiana 141 001 Punjab INDIA

MD Professor Department of Anaesthesia Dayanand Medical College & Hospital LUDHIANA 141 001 Punjab INDIA

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Published

2011-10-13

Issue

Section

Original Research