Comparison of intrathecal Bupivacaine and Bupivacaine with Butorphanol for post-operative analgesia in patients undergoing lower abdominal surgery

Dr. Chaitali Biswas; Dr. Jiban Basak; Dr. Dhurjoti Prosad Bhattacharjee

Volume : VIII, Issue : VIII, August - 2019

Comparison of intrathecal Bupivacaine and Bupivacaine with Butorphanol for post-operative analgesia in patients undergoing lower abdominal surgery

Dr. Chaitali Biswas, Dr. Jiban Basak, Dr. Dhurjoti Prosad Bhattacharjee

Abstract :

Background and Aim Opioids, like butorphanol, have been widely used for providing pain relief postoperatively and the advantages of neuraxial narcotics over systemic narcotics are well established. When compared to local anaesthetics, they offer good analgesia while allowing early ambulation of the patient by sp� sympathetic and motor nerves. The aim of the study was to compare the safety and efficacy of anaesthesia and analgesia of intrathecal bupivacaine-butorphanol mixture with intrathecal bupivacaine alone. Methods: This randomized prospective double-blind active-control study was performed on 60 female patients, aged between 18 and 60 years of ASA physical status I and II undergoing various elective lower abdominal surgeries under spinal anaesthesia. Patients were randomized in two groups, with 30 patients in each group. Patients in the Group B received 3ml (15mg) of 0.5% hyperbaric Bupivacaine plus 25 microgram of Butorphanol (0.25 ml) making a total volume of 3.25 ml and Group C received 3ml (15mg) of 0.5% hyperbaric Bupivacaine plus 0.25 ml of normal saline making a total volume of 3.25 ml intrathecally. Onset and duration of analgesia were recorded. The efficacy of analgesia was recorded based on VAS score. Side effects, time of recovery also were noted. Results and observations: The two groups were comparable regarding the demographic profile. The onset of sensory block was delayed in group C (3.4 � 1.3 min) when compared to group B (2.73 � 0.78 min). The duration of sensory block as well as motor block was prolonged in butorphanol group (376.53 � 10.32 mins) and (149.47 � 6.76 min) respectively as compared to bupivacaine group (144.37 � 25.32 min) and (135.63 � 30.74 min) respectively. Both the findings were significant. Butorphanol provided a significantly longer duration of postoperative analgesia (432.60� 12.04 vs 140.03 � 26.46 mins). No drug related side effects were observed in either group. Conclusions: Intrathecal bupivacaine-butorphanol mixture provides longer duration of sensory blockade and superior analgesia than intrathecal bupivacaine alone.