Comparative Evaluation of two Doses of Epidural Butorphanol with Bupivacaine for Postoperative Analgesia

Abstract

Background: Postoperative analgesia is very important to prevent subjective discomfort, early mobilization and shortened hospital stay. Opioids addition to local anesthetics improve the quality of analgesia. Present study was designed to evaluate and compare the duration and efficacy of two different doses of epidural Butorphanol for postoperative analgesia. Patients and Methods: This prospective, randomized double blinded study was conducted on 75 patients in the age group of 20-60 years of either sex, with ASA class I and II scheduled for elective lower limb orthopedic surgeries under combined spinal epidural anesthesia after taking the informed consent and approval from hospital ethical committee. Group allocation, group I (n=25) received epidural 0.25 % bupivacaine, group II (n= 25) patients received 0.25% epidural Bupivacaine and 1 mg Butorphanol, group ΙΙΙ (n= 25) patients received 0.25% epidural Bupivacaine and 2 mg Butorphanol. Postoperatively VAS, sedation score, vitals & side effects were observed. Injections were given on achieving VAS>3. Results: Onset of analgesia was significantly shorter in group III as compare to group II and group I. Duration of analgesia was longest in group ΙII 9.95±0.43 hour which was significantly greater than group I 3.90±0.32 hours and group ΙΙ 6.06±0.26 hours. Postoperative VAS scores at different intervals were lower in group III than group II and group I (group III< group II< group I). Sedation scores were significantly higher in butorphanol group with no major adverse effects. Conclusion: Butorphanol 2 mg with 0.25% bupivacaine appears to be the optimal dose to produce a more rapid onset and longer duration of analgesia with no adverse effects. Keywords: Epidural; Postoperativanalgesia; Butorphanol.