A COMPARATIVE STUDY OF EPIDURAL BUTORPHANOL AND TRAMADOL FORPOSTOPERATIVE ANALGESIA IN ORTHOPEDIC LOWER LIMB SURGERIES

Abstract

Post operative pain management is a challenge in anaesthesia practice. Many opioids are available for epidural use with various side effects. The main objectives of the study is to asses and compare the postoperative analgesia and quality of analgesia with epidural butorphanol or tramadol in patients undergoing orthopaedic lower limb surgeries. 100 patients of either sex, belonging to 20-60 yrs of age, ASA grade I and II admitted for orthopedic lower limb surgeries were included in the study. In the post-operative period when the patients visual analogue score >4 received either 1 mg of butorphanol (group B) or 50 mg of tramadol (group T) diluted to 10 ml with normal saline. We monitored and compared the Onset ,Duration , Quality of analgesia, consciousness, Cardio-respiratory and Side effects. the mean time of onset of analgesia in group-T was 13.28±2.04 min and in group-B was 11.20±1.02 min, which is statistically significant(p<0.01). The duration of action of analgesia in group-T was 369.8±25.6 min and in group-B was 215.2±26.0 min which is Statistically significant as ‘p’ value is <0.01. Quality of Analgesia (VRS) was better with butorphanol group. The Quality of Analgesia (VRS) in group-T was 3.22±0.54 (SD) min and in group-B was 3.62±0.49 (SD) min (p<0.01) which is statistically significant. Sedation Score was significantly higher with butorphanol group at first hour(P<0.01). Tramadol group had significantly higher incidence of nausea and vomiting(P,0.01). In conclusion epidural butorphanol is better then epidural tramadol for post-operative analgesia. Epidural butorphanol produces faster onset of analgesia , but the duration of analgesia is lesser when compared to tramadol . Side effects like nausea and vomiting are less in butorphanal group but sedation score was higher. Patient satisfaction was better in butorphanol group