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Assessment of Intraoperative Hemodynamics and Recovery Characteristics in Pediatric Patients Receiving Buprenorphine
Prabha Rashmi Lakra1, Pooja Thaware2, Bharati3
1Department of Anesthesiology and Critical Care (Superspeciality), Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
Insights
This study found that buprenorphine and propofol anesthesia effectively managed hemodynamic parameters and provided pain relief for children undergoing cleft palate surgery. Patients experienced a smooth recovery with minimal pain and agitation.
Area of Science:
- Anesthesiology
- Pediatric Surgery
Background:
- Cleft palate surgery requires stable hemodynamics and pain management in young children.
- Optimal anesthesia is crucial for successful surgical outcomes and patient recovery.
Purpose of the Study:
- To evaluate the efficacy of a buprenorphine and propofol anesthesia technique for cleft palate surgery.
- To assess hemodynamic stability, surgical field quality, and postoperative recovery.
Main Methods:
- A prospective observational study included 42 pediatric patients undergoing cleft palate repair.
- Anesthesia involved sevoflurane/propofol induction, buprenorphine, and propofol infusion.
- Hemodynamic parameters, awakening time, surgeon satisfaction, pain, and recovery scores were recorded.
Main Results:
- Buprenorphine and propofol maintained stable hemodynamics and improved the surgical field, increasing surgeon satisfaction.
- Postoperative pain was effectively managed for 2.5 hours, with minimal need for rescue analgesia.
- 90% of patients exhibited calm recovery with no emergence agitation, and high recovery scores were maintained.
Conclusions:
- A single dose of buprenorphine with propofol infusion is effective for cleft palate surgery.
- This technique ensures hemodynamic stability, a bloodless field, and good postoperative pain management.
- The buprenorphine-propofol combination promotes a favorable recovery profile in pediatric patients.
Background:
Children with cleft palate are usually operated on before 18 months of age. Cleft palate surgery demands stable hemodynamic parameters, a bloodless surgical field, and an awake and pain-free child after surgery.
Aims:
We aimed to study the anesthesia technique using buprenorphine and propofol for cleft palate surgery.
Settings And Design:
The design involves prospective observational study. The study was conducted at a tertiary care hospital.
Materials And Methods:
After the Institutional Ethics Committee approval, 42 patients aged 6 months to 12 years undergoing cleft palate surgery were enrolled. Anesthesia induction commenced with sevoflurane or propofol 3 mg.kg-1. After intubation, buprenorphine 3 μg.kg-1 was given, and propofol infusion was started at 2-8 mg.kg-1.h-1. Hemodynamic parameters, awakening time, and surgeon's satisfaction score were noted. After extubation, pain score, emergence agitation (EA) score, sedation score, recovery score, and adverse events were noted.
Statistical Analysis:
All statistical analyses were performed using the 20.0 version of the Statistical Package for the Social Science (SPSS) software program. Continuous data were summarized as mean and standard deviation, and were analyzed using a two-sided Student's unpaired t-test. Categorical data were represented using frequencies and proportions.
Results:
The single dose of buprenorphine with propofol infusion started immediately postintubation causes a significant decrease in heart rate after 1 h. This contributed to a favorable operative field, increasing the surgeon's satisfaction score. In the recovery room, patients were essentially pain-free till 2.5 h after surgery, with only one patient requiring rescue analgesia. Furthermore, 90% of patients showed a smooth and calm recovery with no EA. The Steward's recovery score remained high throughout without any complication.
Conclusions:
In cleft palate surgeries, a single-dose buprenorphine 3 μg.kg-1 and propofol maintenance infusion 2-8 mg.kg-1.h-1 were effective in maintaining hemodynamic parameters and a bloodless surgical field and managing postoperative pain with a good recovery profile.
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