Comparative analysis of post-operative analgesic requirements in patients undergoing minor oral surgery using buprenorphine with lignocaine versus lignocaine: a clinical study

Neel Kamal; Alfisha Sheikh; Vaz Ashwin Alwyn; Navneet Kaur; Chandra Shekhar; Amit Sharma

doi:10.18203/2320-6012.ijrms20223089

Authors

Neel Kamal Department of Oral and Maxillofacial Surgery, Rajasthan Dental College and Hospital, Jaipur, Rajasthan, India
Alfisha Sheikh Department of Oral and Maxillofacial Surgery, Rajasthan Dental College and Hospital, Jaipur, Rajasthan, India
Vaz Ashwin Alwyn Department of Oral and Maxillofacial Surgery, Rajasthan Dental College and Hospital, Jaipur, Rajasthan, India
Navneet Kaur Department of Oral and Maxillofacial Surgery, Laxmibai Dental College, Patiala, Punjab, India
Chandra Shekhar Department of Meda Daulati Hospital, Bharatpur, Rajasthan, India
Amit Sharma Department of Oral and Maxillofacial Surgery, Rajasthan Dental College and Hospital, Jaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20223089

Keywords:

Buprinorphine, Lignocaine, Minor oral surgery

Abstract

Background: We aimed to inspect the post -operative analgesic requirement in patient undergoing minor oral surgery using buprenorphine versus lignocaine and lignocaine alone. Minor oral surgeries are followed by inflammatory reaction characterized by pain, mild swelling and discomfort. Opioid analgesics have an advantage over non-steroidal anti-inflammatory drugs (NSAIDs) as they do not cause organ damage. Buprenorphine has an antinociceptive potency greater than that of morphine. Hence, in this study, buprenorphine was added to lignocaine in relieving postoperative pain after minor oral surgery.

Methods: A total of 100 patients requiring minor oral surgery were included in the study. The patients were randomized by a third party and allocated to one of the two study groups. Hence a total of 50 patients in each group were selected for study, during a period of 24 months. 1 ml of buprenorphine hydrochloride injection I.P which contains an equivalent of 0.3 mg buprenorphine was withdrawn into a syringe and injected into a 30 ml vial of 2% lignocaine with adrenaline 1:200000.

Results: The pain was found to be statistically significant at 2-hour, 24 hour and 36 hours postoperatively, thereafter the difference in NRS values between the solutions was not significant. Hence, the analgesic effect of solution A (buprenorphine) was effective at 2-hour, 24 hour and 36 hours postoperatively.

Conclusions: Our study indicate that addition of 0.3 mg of buprenorphine to local anesthetic solution provides efficient post-operative analgesia and reduces patient's discomfort.

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Author Biography

Neel Kamal, Department of Oral and Maxillofacial Surgery, Rajasthan Dental College and Hospital, Jaipur, Rajasthan, India

Professor ,Dept. of Oral & Maxillofacial Surgery , Rajasthan Dental College & Hospital , Jaipur

References

Stein C. Peripheral mechanism of opioid analgesia. Anesth Analg. 1993;76:182-91.

Malamed SF. Modern Dental Pain Control. International Dentistry SA. 2007;11:44-56.

Likara R, Sittlb R, Graggerc K, Pipama W, Blatnigc H, Breschana C, Schalka HV, Steind C, Schafer M. Peripheral morphine analgesia in dental surgery. Pain. 1998;76:145-50.

Likar R, Koppert W, Blatnig H, Chiari F, Sitt R, Stein C, Schafer M. Efficacy of peripheral morphine analgesia in inflamed, non-inflamed and perineural tissue of dental surgery patients. J Pain Symptom Manage. 2001;21:330-7.

Kaczmarzyk T, Stypulkowska J. Assessment of the effectiveness of peripheral administration of morphine with local Articaine anesthesia for surgery in inflamed oral and maxillofacial tissues Pain. 2005;115:348-54.

Bhananker SM, Azavedo LF, Splinter WM. Addition of morphine to local anesthetic infiltration does not improve analgesia after pediatric dental extractions. Paediatr Anaesth. 2008;18:140-4.

Kumar SP, Suryavanshi RK, Kotrashetti SM. Efficacy of Buprenorphine added 2 % Lignocaine 1:80000 in postoperative analgesia after minor oral surgery J Maxillofac Oral Surg. 2013; 12:30-4.

Comer SD, Collins ED. Self-Administration of intravenous Buprenorphine and the Buprenorphine/Naloxone combination by recently detoxified heroin abusers. J Pharmacol Exp Ther. 2002;303:695-703.

Candido D, Franco CD, Khan MA, Winnie AP, Raja DS. Buprenorphine added to the local anesthetic for brachial plexus block to provide postoperative analgesia in outpatients Region Anesth Pain. 2001;26:352-6.

Modi M, Rastogi S, Kumar A. Buprenorphine with bupivacaine for intraoral nerve blocks to provide postoperative analgesia in outpatients after minor oral surgery. J Oral Maxillofac Surg. 2009;67:2571-6.

Dobkin A, Esposito B, and Philbin C Double-Blind evaluation of Buprenorphine Hydrochloride for post-operative pain. Canad Anaesth Soc J. 1977;24:9-12.

Comer SD, Collins ED. Self-Administration of intravenous Buprenorphine and the Buprenorphine/Naloxone combination by recently detoxified heroin abusers. J Pharmacol Exp Ther. 2002;303:695-703.

Walter DS, Inturrisi CE. Absorption, distribution, metabolism and excretion of buprenorphine in animals and humans. EurekaMag. 1995;14:113-35.

Fang J, Hwang T, Huang Y, Tsai YH. Transdermal iontophoresis of sodium nonivamide acetate. Combined effect of physical enhancement methods Int J Pharm. 2002;235:95-105.

Malamed SF. Modern Dental Pain Control. International Dentistry SA. 2007;11:44-56.

Bazin JE, Massoni C, Bruelle P, Fenies V, Groslier D, Schoeffler P. The addition of opioids to local anaesthetic in brachial plexus block: the comparative effects of morphine, buprenorphine and sulfentanil. Anaesthesia. 1997;52;9:858-62.

Viel EJ, Eledjam JJ, De La Coussaye JE, D'Athis F. Brachial plexus block with opioids for postoperative pain relief: comparison between buprenorphine and morphine. Reg Anesth. 1989;14:274-8.