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Journal of Anesthesia

, Volume 26, Issue 5, pp 746–751 | Cite as

Buprenorphine added to levobupivacaine enhances postoperative analgesia of middle interscalene brachial plexus block

  • Astrid Behr
  • Ulderico FreoEmail author
  • Carlo Ori
  • Brigitte Westermann
  • Fernando Alemanno
Original Article

Abstract

Purpose

The aim of this study was to assess whether addition of epineural buprenorphine prolonged postoperative analgesia of middle interscalene brachial plexus block (MIB) with levobupivacaine.

Methods

One hundred and fifty consenting adult patients, scheduled for shoulder arthroscopic surgery for a rotator cuff tear under MIB with 29.5 ml of 0.75 % levobupivacaine, were randomized to receive additionally either saline or intramuscular buprenorphine 0.15 mg or epineural buprenorphine 0.15 mg. Onset of sensory and motor blocks, duration of postoperative analgesia, and consumption of postoperative analgesics were compared among the groups.

Results

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 ± 242.2 min) than in patients who had received intramuscular buprenorphine (693.6 ± 143.4 and 820.3 ± 335.3 min) or saline (488.3 ± 137.6 and 637.5 ± 72.1 min). 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.

Conclusions

Epineural buprenorphine prolonged postoperative analgesia of MIB more effectively than intramuscular buprenorphine, which suggests that buprenorphine acts at a peripheral nervous system site of action.

Keywords

Brachial plexus block Buprenorphine Postoperative analgesia 

Notes

Acknowledgments

This study was supported only by departmental funds.

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Copyright information

© Japanese Society of Anesthesiologists 2012

Authors and Affiliations

  • Astrid Behr
    • 1
  • Ulderico Freo
    • 1
    Email author
  • Carlo Ori
    • 1
  • Brigitte Westermann
    • 2
  • Fernando Alemanno
    • 2
  1. 1.Department of Pharmacology and AnesthesiologyUniversity of PadovaPadua (PD)Italy
  2. 2.Department of Anesthesia and Pain TherapySan Camillo HospitalBrescia (BS)Italy

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