European Journal of Biomedical and Pharmaceutical Sciences

MIDAZOLAM VS. BUPRENORPHINE: PATIENT CONTROLLED EPIDURAL ANALGESIA FOR POSTOPERATIVE PAIN IN GASTRECTOMY

Tomoki Nishiyama*

ABSTRACT

The purpose of this study was to compare the effects between midazolam and buprenorphine in postoperative patient controlled epidural analgesia. Forty patients aged 30 to 70 years with ASA physical status I or II for gastrectomy were enrolled. After insertion of an epidural catheter, general anesthesia was induced with thiopental, fentanyl, and vecuronium, and maintained with sevoflurane, nitrous oxide in oxygen with intermittent epidural injection of 1.5% lidocaine. At the end of surgery, 0.25% bupivacaine 5 mL + midazolam 3 mg (Midazolam group) or + buprenorphine 0.1 mg (Buprenorphine group) was epidurally injected followed by continuous epidural infusion at 3.3 mL/h for 24 hours with patient controlled analgesia (PCA) of 3 mL (lock out time of 30 minutes). The contents of the infuser were 0.25% bupivacaine 38 mL + midazolam 10 mg (Midazolam group) or 0.25% bupivacaine 39 mL + buprenorphine 0.2 mg (Buprenorphine group) for 12 hours and continued for 24 hours. Intramuscular pentazocine 15 mg was the rescue after PCA. Blood pressure, heart rate, respiratory rate, percutaneous oxygen pressure (SpO2), visual analog score (VAS) for pain, sedation level, the number of the PCA and pentazocine usage, and nausea and vomiting were monitored for postoperative 24 hours. All parameters measured were not different between the two groups. From these results, epidural PCA with midazolam had similar effects with buprenorphine when used for postoperative analgesia in gastrectomy.

Keywords: Postoperative analgesia, epidural block, patient controlled, analgesia, midazolam, buprenorphine, gastrectomy.