Comparative Study of Epidural Butorphanol & Epidural Fentanyl for the Relief of Post Operative Pain in Lower Abdominal & Lower Limb Surgery
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2017, Vol 4, Issue 2
Abstract
Background and Aim: Post operative pain relief is an essential part of responsibility for an anaesthesiologist. Epidural opioids acting through the spinal cord receptors improve the quality and duration of analgesia. The present study compared the efficacy and safety profile of epidurally administered butorphenol and fentanyl. Methods: In this double blinded study, 60 patients undergoing lower abdominal and lower limb surgery were randomly divided into two groups by computer generated random number. In all patients, epidural space is located at L2 L3 space using 18G Tuohy needle with loss of resistance technique.20G catheter passed through needle till about 23cm of catheter was in space. Test dose was injected. After 5 min, induction was done with spinal anaesthesia with inj. Bupivacaine heavy 0.5% 3cc at same lumber space in sitting position. Group A patients received epidural Butorphenol 1mg diluted in 10ml Ns as first dose post op when VAS>5 and top up dose 0.5 mg diluted in 10ml NS when VAS>5. Group B patients received epidural fentanyl 100microgram diluted in 10ml NS as first dose post op when VAS>5 and top up dose fentanyl 50microgram diluted in 10ml NS when VAS>5.Vital parameter, onset, duration, quality of analgesia, side effects, VAS score, sedation score were observed. The data was collected and tabulation formed and statistical analysis of continuous data was done by unpaired student “t” test and chisquare test was applied for discrete data. Results were considered statistically significant with p value <0.05 and highly significant with p value <0.001. Results: Demographic profiles of patients were comparable in both the groups. Onset of analgesia was earlier in fentanyl group than butorphenol group. Butorphenol provides longer duration of analgesia compared to fentanyl group. Quality of analgesia was better with butorphanol than fentanyl. Conclusion: Butorphanol and fentanyl both drugs are safe to provide analgesia via epidural route in post operative period without significant side effects. Fentanyl is having earlier onset with short duration of analgesia while butorphanol provide analgesia for longer duration with delayed onset.
Authors and Affiliations
Ushma D. Shah
Keywords
Related Articles
- EP ID EP464900
- DOI 10.21088/ijaa.2349.8471.4217.9
- Views 111
- Downloads 0
Effectiveness of Dexamethasone as an Adjuvant to Local Anesthetic Mixture in Supraclavicular Brachial Plexus Block
Adjuvant drugs are used to prolong the analgesic effects of local anesthetics in regional nerve blocks. This study was done to show the efficacy of Dexamethasone as a potent adjuvant in Supraclavicular Brachial plexus bl...
Estimation of an Efficient Antiemetic Agent for Prevention of Postoperative Nausea and Vomiting in Children Undergoing Tonsillectomy
Postoperative nausea and vomiting (PONV) remains one of the commonest causes of significant morbidity after tonsillectomy in children. A variety of prophylactic antiemetic interventions have been reported, but there has...
Comparison of Trans-Foraminal Epidural Triamcinolone with or Without Local Anesthetic in Lumbar DISC Herniation for Pain Relief
Low back pain is a leading cause of disability and the commonest cause is intervertebral disc degeneration. We decide to compare the efficacy and safety of transforaminal epidural triamcinolone with or without local anae...
Rocuronium Versus Vecuronium in Endotracheal Intubation and Maintenance in General Anaesthesia\
Introduction: Adequate maintenance of airways in patients undergoing surgeries under general anaesthesia was through proper intubation. Succinylcholine was the most opted neuromuscular drug in the past 50 years administe...
Selective Left Endobronchial Intubation in Paediatric Cases: Lesson Learnt Using Single Lumen Tube
Background: Selective left endobronchial intubation in right thoracoscopy is technically demanding. We are presenting our mid term experience of selective left bronchus intubation using the previously published maneuver...