A Comparative Study of Epidural Butorphanol and Fentanyl as Adjuvants with 0.5% Bupivacaine for Postoperative analgesia in Lower Abdominal Surgeries

Abstract

The pain is considered as sixth vital sign. Achieving adequate peri-operative and post -operative analgesia is of paramount importance to the anesthesiologist. This can be done by multiple approaches. One such technique is use of Epidural opioids. This study evaluates the analgesic efficacy of epidural fentanyl and butorphanol in lower abdominal surgeries for post -operative analgesia. Aims: To compare the degree of post-operative analgesia using butorphanol and fentanyl administered by epidural route. Settings and Design: Study setting: Tertiary care Hospital Study Design: A Prospective Double Blinded Randomised Clinical Study Methods and Material: A total of 60 Patients posted for elective lower abdominal surgeries were randomly selected for the study. The patients aged 20-60 years of ASA grade one and two posted for elective lower abdominal surgery were selected for the study. Drugs used were explained to the patients and also educated about Verbal numerical scale for assessment of pain. Patients were divided into two groups: Group A: receives Butorphanol 1mg mixed with 15 ml Bupivacaine 0.5%diluted upto 20 ml. Group B: receives Fentanyl 100 microgram mixed with 15 ml Bupivacaine 0.5% diluted upto 20 ml. Statistical analysis used: Statistical data was analysed using • Chi-square test • Student t-test (Paired and unpaired t-test) • A P value of < 0.05 is significant and >0.05 is not significant Results: The demographic variables were comparable in both groups. Both inj. Butorphanol 1 mg and Inj. Fentanyl 100 mcg given epidurally with Inj. Bupivacaine 0.5% as a single shot provided excellent operative conditions and satisfactory post-operative analgesia in both the groups. However, the duration of post-operative analgesia was much longer in the butorphanol group than Fentanyl group and was statistically significant. No serious side effects were noted in both groups. The method is economical, safe, convenient and acceptable and also poly pharmacy is avoided. Conclusions: Both fentanyl and butorphanol are safe and effective as epidural agents for postoperative analgesia with little side effects.