Epidural buprenorphine for postoperative analgesia in spinal surgery

Background and objectives : Postoperative pain management with the epidural administration of opioids and 7 other additives has been widely reported. Non-availability of newer opioids limits their use in developing countries. In our trial we are demonstrating the efficacy of epidural use of buprenorphine in moderate to severe postoperative pain of spinal surgery Methods : This is a prospective case series of 18 patients who underwent laminectomy or discectomy. All patients had conventional general anesthesia. Intraoperative pain was managed with meperedine. Before closure of incision epidural catheter was inserted under direct vision in all patients. Buprenorphine 2.5μg kg ^-1 in total volume of 10ml was given before extubation and then 12 hourly for 48 hours. Pain scores, need for rescue analgesics, adverse effects of buprenorphine and patient ambulation were monitored. Results : 10 male and 8 female patients entered in this trial, they all responded well to epidural buprenorphine, only two patients needed rescue analgesia on the first postoperative day. Two patients complained of nausea, while urinary retention was noted in one patient. Early ambulation within 24 hour was recorded in all patients. Conclusion : Epidural buprenorphine can be safely used for postoperative pain in patients after spinal surgery.