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
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- EP ID EP550525
- DOI 10.14260/jemds/2018/1243
- Views 58
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