Benefits of using intrathecal Buprenorphine

Background: General anesthesia draw the most commonly used modalities for post cesarean delivery pain relief is systemic administration of opioids, while the administration of small dose of intrathecal opioid during spinal anesthesia can be a possible alternative. The aim of this study was to evaluate the effects of buprenorphine on cesarean section prescribed intrathecally. Methods: In this double blind randomized clinical trial, all scheduled patients for cesarean section under spinal anesthesia were enrolled. The patients were randomly divided into 2 groups. Case group received 65-70mg of 5% lidocaine plus 0.2 ml of buprenorphine while the same amount of 5% lidocaine diluted with 0.2 ml of normal saline was given to the control group. Hemodynamic changes and neonatal APGAR scores (Appearance, Pulse, Grimace, Activity, Respiration) were recorded. Pain score was recorded according to the Visual Analogue Scale. Results: Systolic blood pressure was not significantly different until 45th minutes but diastolic blood pressure showed a significant difference at the 15th and 60th minutes (P-value<0.001). Heart rate changes were significantly different between cases and controls at the initial 5th, 15th and after 60th minutes (P<0.001). Pain-free period was significantly different between the two groups (1.25 h versus 18.73 h) (P<0.001). Conclusion: The results show that prescription of intratechal bupernorphine prolong the duration of analgesia without any significant considerable side effects.