Does Epidural Buprenorphine Really Shorten the Duration of Endotracheal Intubation, Ventilatory Support and Intensive Care Unit (ICU) Stay in Open Heart Surgery Patients?

Chae,  Byung Kook; Lee,  Hye Won; Lim,  Hae Ja; Chang,  Seong Ho

doi:.31.3.380

DOI: https://doi.org/10.4097/kjae.1996.31.3.380

Byung Kook Chae, Hye Won Lee, Hae Ja Lim, Seong Ho Chang

Korea University, College of Medicine, Department of Anesthesia, Annam Hospital, Seoul, Korea.

Abstract

BACKGROUND
Epidural buprenorphine has been shown to reduce the anesthetic and analgesic requirements during the perioperative period. The goal of this study is to see whether epidural buprenorprhine reduce the dose of fentanyl infusion for anesthetic management and postoperative pain control and shorten the duration of postoperative ventilatory support and endotracheal intubation in open heart surgery patients.
Method
Total 50 patients who underwent the open heart surgery were included for the study. General anesthesia was maintained with a nitrous oxide (2 L/min)-oxygen (2 L/min)-isoflurane (0.5~1.5 %). In control group additional anesthetic requirement is supplemented with intermittent intravenous injection of fentanyl. In buprenorphine group initial loading dose of 0.3 mg of epidural buprenorphine followed by continuous epidural infusion (20 microgram/hr) and additional anesthetic requirement was supplemented with intravenous fentanyl.
RESULTS
The total dose of fentanyl requirement was significantly lower in buprenorphine group than in control group. The duration of ventilatory support and endotracheal intubation were significantly shorter in buprenorphine group than in control group. The duration of ICU stay was not different between two groups.
CONCLUSIONS
Epidural buprenorphine reduced the anesthetic requirement and postoperative pain and shortened the duration of postoperative ventilatory support and endotracheal intubation. Therefore epidural buprenorphine can be an reasonable alternative for an adjunctive with general anesthesia and postoperative pain control.

Key Words: Anesthetic techniques epidural; thoracic; Surgery open heart; Pharmacology buprenorphine; Ventilation mechanical