COMPARISON OF DIFFERENT DOSES OF EPIDURAL BUTORPHANOL 2 MG/4 MG AS ADJUVANT TO 0.125% BUPIVACAINE FOR POSTOPERATIVE ANALGESIA FOR VARIOUS INFRAUMBILICAL SURGERIES
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 53
Abstract
BACKGROUND Postoperative analgesia is wide spread in this era. There are multimodal techniques available for same. The aim of this study was to compare efficacy, effectiveness, safety, of different doses of butorphanol as adjuvant to Bupivacaine 0.125% for postoperative analgesia. Study design was randomised double blind comparative study MATERIALS AND METHODS This randomized clinical comparative study was conducted in 50 patients of either sex, aged between 18- 60 years of ASA grade Ι and ΙΙ admitted for elective surgery. Written informed consent was taken and pre-anaesthetic evaluation was done. Epidural catheter was inserted, and all patients were given spinal anaesthesia using 0.5% hyperbaric bupivacaine (15 mg). In the postoperative period, when patient complained of pain, or VAS score was 3 or more, study drug was given. In group A, epidural bupivacaine (0.125%) 10 ml and preservative free butorphanol 2 mg diluted to 2 ml with NS, & in Group B, bupivacaine (0.125%) 10 ml and preservative free butorphanol 4 mg diluted to 2 ml with NS was given. Parameters observed were; onset of analgesia; duration of analgesia; cardio- respiratory effects and adverse effects. Data was analysed with SPSS Software 16 (IBM, Armonk, NY, USA). Unpaired t test, was used for qualitative data. chi-square test used for categorical data (n, number, %). RESULTS Age, sex, weight, haemodynamics, and ASA grade were comparable in both groups. Mean onset of analgesia was rapid (4.5+1.06) minutes) in group B when compared to group A (6.0 +1.32 minutes). This was clinically and statistically significant (p< 0.001). Duration of analgesia was longer in group A which was mean of 410+50.29 minutes compared to group B which was with a mean of 490+39.32 minutes. This was clinically and statistically significant (p< 0.001). 24-hour VAS was 3.0+/-1. 2 in Group A, 2. 5+/-1.0 in Group B. Total Analgesic request in 24 hours was 2 +/- 0.5 in group A, 1 +/- 0.2 in group B. There was no significant difference in heart rate, blood pressure, and respiratory rate, as monitored at regular intervals postoperatively between the two study groups. Regarding adverse reactions, sedation was the main side effect in group B (40%) patients, in group A it was (36%). Frequency of pruritis 4% and nausea-vomiting was more in group B (12%), in group A it was 0% & 8% respectively. Hypotension and respiratory depression were in 4% patients in group B which was statistical insignificant. All patients were monitored for 24 hours postoperatively for any untoward effects & for haemodynamic stability as well as for VAS. CONCLUSION Butorphanol is good adjuvant to 0.125% bupivacaine in epidural analgesia. 4 mg butorphanol provides prolonged analgesia than 2 mg.
Authors and Affiliations
Manisha S. Kapdi, Rupal J. Shah, Dhruvini Patel, Khyati Patel
Keywords
Related Articles
- EP ID EP550525
- DOI 10.14260/jemds/2018/1243
- Views 78
- Downloads 0
PREVALENCE OF CORONARY ARTERY DISEASE IN PATIENTS WITH VALVULAR HEART DISEASE
t disease is a growing problem, particularly in developing countries. India has quoted to have 12.2% and 12% prevalence of coronary artery disease and rheumatic valvular heart disease respectively. Some older rep...
A STUDY ON CLINICAL FEATURES, AETIOLOGY, OUTCOMES AND PREDICTORS OF MORTALITY AND MORBIDITY IN CHILDREN WITH ACUTE ENCEPHALITIS SYNDROME IN EASTERN INDIA
BACKGROUND Acute Encephalitis Syndrome (AES) is a common condition leading to hospitalisation of children in India. Infective aetiology remains the most common cause till date. Various studies have been conducted to find...
COMPARATIVE STUDY BETWEEN INTRAVENOUS DEXAMETHASONE VERSUS KETAMINE GARGLE VERSUS INTRAVENOUS DEXAMETHASONE COMBINED WITH KETAMINE GARGLE FOR EVALUATION OF POST-OPERATIVE SORE THROAT AND HOARSENESS IN MIDDLE EAR SURGERY
BACKGROUND Endotracheal intubation is the common cause of trauma to the airway mucosa, resulting in post-operative sore throat (POST) and hoarseness. This study was done to evaluate and compare the effectiveness of proph...
A STUDY ON PULMONARY INVOLVEMENT IN CHRONIC RHEUMATOID ARTHRITIS WITH CHEST XRAY AND SPIROMETRY IN A TEACHING HOSPITAL
BACKGROUND Rheumatoid arthritis (RA) is a chronic systemic inflammatory disorder with a 0.5% - 2% prevalence in the general population. 50% of patients with chronic RA exhibit pulmonary involvement. Patients with RA shou...
ADOLESCENT HEAVY MENSTRUAL BLEEDING AND RESPONSE TO TREATMENT WITH REFERENCE TO BMI
BACKGROUND Adolescent heavy menstrual bleeding is excessive bleeding occurring in the age group of 13 - 19 years for more than 7 days or more than 80 mL. The common cause for this is due to immaturity of HPO axis in the...