Randomized Controlled Study Fentanyl Vs Buprenorphine as Adjuvants in Subarachnoid Block with 2-chloroprocaine in Anorectal Surgery

The subarachnoid block is a safe and reliable anaesthesia technique in outpatient daycare surgeries. The aim of the present study was to compare postoperative analgesic efficacy between 2-chloroprocaine + 25 µg fentanyl, 2-chloroprocaine + 60 µg buprenorphine and 2-chloroprocaine while giving the subarachnoid block in anorectal surgery. This randomised controlled study was conducted in 105 patients. All the patients received 2-chloroprocaine 40 mg. In addition, Group A and Group B patients received 25 µg fentanyl and 60 µg buprenorphine respectively. Group C patients received only 2-Chloroprocaine. The visual analogue scale (VAS) score was recorded immediately, and at 2, 4, 6 h. Postoperative nausea and vomiting (PONV) were noted. The primary outcome measures were to compare the VAS score and the requirement of the use of rescue analgesia, whereas the secondary outcome measure was to compare the incidence of PONV. The mean VAS score was significantly lower in Group B as compared to Group A and Group C. The incidence of PONV was significantly higher in Group B (17.1 %) as compared to Group A (5.7 %) and Group C (8.6 %). The postoperative requirement of the use of rescue analgesia was significantly higher in Group A (17.1 %) compared to Group B (5.7 %). The duration of analgesia was significantly higher in Group B as compared to Group C. An addition of buprenorphine reduced a requirement of the use of rescue analgesia but was associated with an increased incidence of nausea and vomiting