{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T20:31:54Z","timestamp":1786739514866,"version":"build-2736575974"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>The synergism between intrathecal opioids and low dose local anesthetics makes it possible to achieve reliable spinal anesthesia (SA) with minimal hypotension. The study objective was to compare the hemodynamic effects of reduced dose of 0.5% intrathecal bupivacaine (2mL) with 25 \u03bcg butorphanol in cardiac vs non-cardiac patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods:<\/jats:title>\n                    <jats:p>We included sixty patients aged 30-80 years, undergoing infraumbilical surgeries in the study and compared thirty cardiac patients with mild to moderate reduction in left ventricular ejection fraction (LVEF) on 2D echocardiography (Group C) with 30 non-cardiac patients (Group NC) for similar types of surgery. Both the groups received 0.5% bupivacaine 2.0 ml with 25 \u03bcg butorphanol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The spinal block characteristics were similar in both groups (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05). The blood pressure of the patients in the two groups was comparable till 80 min\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05 after which Group NC had significant increase in blood pressure compared to Group C upto 95 min (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05). Similarly, heart rate was comparable until 90 min (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05) after which Group NC had significant increase in heart rate versus Group C upto 100 min (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05). Eight patients in group C and five patients in group NC showed hypotension. Bradycardia was seen in 4 patients in group C in comparison to only one patient in group NC.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>We can safely consider spinal anesthesia with 10 mg bupivacaine and 25\u03bcg butorphanol in cardiac patients with mild to moderately reduced ejection fraction presenting for infraumbilical non-cardiac surgeries with the advantage of intraoperative hemodynamic stability and adequate postoperative analgesia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/joacp.joacp_70_20","type":"journal-article","created":{"date-parts":[[2021,1,18]],"date-time":"2021-01-18T07:20:28Z","timestamp":1610954428000},"page":"511-517","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Comparative study of hemodynamic effects of intrathecal bupivacaine with butorphanol in cardiac and non-cardiac patients"],"prefix":"10.4103","volume":"36","author":[{"given":"Ruchi","family":"Gupta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepika","family":"Arora","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shubhdeep","family":"Kaur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Balpreet","family":"Kaur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sukhvir","family":"Kaur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-15-20260203","doi-asserted-by":"crossref","first-page":"705","DOI":"10.4103\/ija.IJA_384_17","article-title":"The patient with ischaemic heart disease undergoing non cardiac surgery","volume":"61","author":"Hedge","year":"2017","journal-title":"Indian J Anaesth"},{"key":"R2-15-20260203","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1097\/00000542-200001000-00007","article-title":"Minidose bupivacaine-fentanyl spinal anesthesia for surgical repair of hip fracture in the aged","volume":"92","author":"Ben-David","year":"2000","journal-title":"Anesthesiology"},{"key":"R3-15-20260203","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1097\/00000542-200105000-00030","article-title":"Current issues in spinal anesthesia","volume":"94","author":"Liu","year":"2001","journal-title":"Anesthesiology"},{"key":"R4-15-20260203","first-page":"94","article-title":"Subarachnoid block with low dose of bupivacaine and sufentanil in patients with coronary artery disease","volume":"10","author":"Sanatkar","year":"2014","journal-title":"ARYA Atheroscler"},{"key":"R5-15-20260203","doi-asserted-by":"crossref","first-page":"307","DOI":"10.12998\/wjcc.v5.i8.307","article-title":"Adjuvants to local anesthetics: Current understanding and future trends","volume":"5","author":"Swain","year":"2017","journal-title":"World J Clin Cases"},{"key":"R6-15-20260203","doi-asserted-by":"crossref","first-page":"156","DOI":"10.4103\/0975-2870.110293","article-title":"A study of addition of Inj.butorphanol to hyperbaric Inj bupivacaine given intrathecally to patients undergoing lower segment caesarean section: A randomized, controlled trial","volume":"6","author":"Ranga Chari","year":"2013","journal-title":"Med J DY Patil Univ"},{"key":"R7-15-20260203","doi-asserted-by":"crossref","first-page":"202","DOI":"10.4103\/1658-354X.82804","article-title":"A comparative evaluation of intrathecal bupivacaine alone, sufentanil or butorphanol in combination with bupivacaine for endoscopic urological surgery","volume":"5","author":"Kaur","year":"2011","journal-title":"Saudi J Anaesth"},{"key":"R8-15-20260203","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1254\/jphs.CRJ05001X","article-title":"Butorphanol: Effects of a prototypical agonist-antagonist analgesic on \u03ba-opioid receptors","volume":"98","author":"Commiskey","year":"2005","journal-title":"J Pharmacol Sci"},{"key":"R9-15-20260203","doi-asserted-by":"crossref","first-page":"254","DOI":"10.3389\/fmed.2018.00254","article-title":"Neuraxial anesthesia in the geriatric patient","volume":"5","author":"Sivevski","year":"2018","journal-title":"Front Med"},{"key":"R10-15-20260203","doi-asserted-by":"crossref","first-page":"5675","DOI":"10.14260\/jemds\/2015\/830","article-title":"Comparison of efficacy of butorphanol and fentanyl as intrathecal adjuvant to bupivacaine","volume":"4","author":"Reddy","year":"2015","journal-title":"J Evol Med Dent Sci"},{"key":"R11-15-20260203","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1097\/00000542-199004000-00022","article-title":"Molecular mechanisms of local anesthesia: A review","volume":"72","author":"Butterworth","year":"1990","journal-title":"Anesthesiology"},{"key":"R12-15-20260203","doi-asserted-by":"crossref","first-page":"6196","DOI":"10.14260\/jemds\/1118","article-title":"Postoperative analgesic efficacy of intrathecal tramadol versus nalbuphine added to bupivacaine in spinal anesthesia for lower limb orthopaedic surgery","volume":"2","author":"Verma","year":"2013","journal-title":"J Evol Med Dent Sci"},{"key":"R13-15-20260203","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/S0074-7742(08)60681-9","article-title":"Opioid action on mammalian spinal neurons","volume":"25","author":"Zieglgansberger","year":"1984","journal-title":"Int Rev Neurobiol"},{"key":"R14-15-20260203","doi-asserted-by":"crossref","first-page":"190","DOI":"10.4103\/0259-1162.94775","article-title":"Comparison of intrathecal bupivacaine-fentanyl and bupivacaine-butorphanol mixtures for lower limb orthopedic procedures","volume":"5","author":"Kumar","year":"2011","journal-title":"Anesth Essays Res"},{"key":"R15-15-20260203","first-page":"25","article-title":"Comparative study of low dose bupivacaine-fentanyl vs conventional dose of bupivacaine in spinal anesthesia for orthopedic procedures in elderly patients","volume":"70","author":"Mehta","year":"2015","journal-title":"Guj Med J"},{"key":"R16-15-20260203","first-page":"2066","article-title":"A comparative study of efficacy of intrathecal fentanyl and butorphanol as an adjuvant to bupivacaine 0.5% heavy for lower limb and lower abdominal surgeries","volume":"6","author":"Gupta","year":"2018","journal-title":"Sch J App Med Sci"},{"key":"R17-15-20260203","first-page":"1","article-title":"A comparative study of efficacy of anesthesia and analgesia between intrathecal fentanyl and butorphanol with bupivacaine 0.5% heavy for lower limb orthopedic surgery: A prospective randomized study in a tertiary care teaching hospital","volume":"6","author":"Reddy","year":"2018","journal-title":"Int J Res Health Sci"},{"key":"R18-15-20260203","doi-asserted-by":"crossref","first-page":"508","DOI":"10.4103\/0259-1162.179320","article-title":"A randomized controlled study between fentanyl and butorphanol with low dose intrathecal bupivacaine to facilitate early postoperative ambulation in urological procedures","volume":"10","author":"Kumar","year":"2016","journal-title":"Anesth Essays Res"},{"key":"R19-15-20260203","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1111\/j.1365-2044.1997.074-az0074.x","article-title":"Can ASA grade or Goldman's cardiac risk index predict peri-operative mortality. A study of 16 227 patients?","volume":"52","author":"Prause","year":"1997","journal-title":"Anesthesia"},{"key":"R20-15-20260203","doi-asserted-by":"crossref","first-page":"e77","DOI":"10.1016\/j.jacc.2014.07.944","article-title":"2014 ACC\/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing non-cardiac surgery: A report of the American College of Cardiology\/American Heart Association Task Force on practice guidelines","volume":"64","author":"Fleisher","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"R21-15-20260203","doi-asserted-by":"crossref","first-page":"2185","DOI":"10.1001\/archinte.159.18.2185","article-title":"Self-reported exercise tolerance and the risk of serious perioperative complications","volume":"159","author":"Reilly","year":"1999","journal-title":"Arch Intern Med"},{"key":"R22-15-20260203","first-page":"32236","article-title":"Intrathecal butorphanol: An effective option for post operative pain relief in caesarean patients","volume":"5","author":"Purohit","year":"2017","journal-title":"J Med Sci Clin Res"},{"key":"R23-15-20260203","first-page":"371","article-title":"Comparison among intrathecal fentanyl and butorphanol in combination with bupivacaine for lower limb surgeries","volume":"22","author":"Singh","year":"2006","journal-title":"J Anaesth Clin Pharmacol"},{"key":"R24-15-20260203","first-page":"121","article-title":"Comparison of intrathecal bupivacaine and bupivacaine with butorphanol for postoperative analgesia in patients undergoing lower abdominal surgery","volume":"8","author":"Biswas","year":"2019","journal-title":"Glob J Res Anal"}],"container-title":["Journal of Anaesthesiology Clinical Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/joacp.JOACP_70_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T19:29:36Z","timestamp":1786735776000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/joacp.JOACP_70_20"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10]]},"references-count":24,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.4103\/joacp.joacp_70_20","relation":{},"ISSN":["0970-9185"],"issn-type":[{"value":"0970-9185","type":"print"}],"subject":[],"published":{"date-parts":[[2020,10]]}}}