A COMPARATIVE STUDY OF EPIDURAL BUTORPHANOL AND EPIDURAL FENTANYL AS ADJUVANTS TO BUPIVACAINE IN LOWER ABDOMINAL SURGERIES

DR D.NIRANJAN; DR B.MOHAMED SAMEER; DR.B.JEYARANI

Volume : VII, Issue : XI, November - 2017

A COMPARATIVE STUDY OF EPIDURAL BUTORPHANOL AND EPIDURAL FENTANYL AS ADJUVANTS TO BUPIVACAINE IN LOWER ABDOMINAL SURGERIES

Dr D. Niranjan, Dr B. Mohamed Sameer, Dr. B. Jeyarani

Abstract :

AIM: To compare the efficacy of butorphanol and fentanyl added as adjuvants to bupivacaine in epidural anaesthesia for elective lower abdominal surgeries. MATERIALS & METHODS: 60 patients of either sex, aged between 20–60 years of ASA grade I & II admitted for elective surgeries in a tertiary care hospital. All cases were given epidural anaesthesia using 0.5% bupivacaine with butorphanol 1mg (total volume of 20ml) or 0.5% bupivacaine with fentanyl 100µg(total volume of 20ml) depending on study group BB or BF. In the perioperative period the following parameters were observed,1) Vital parameters–heart rate, SpO2,blood pressure and respiratory rate,2)Onset and completion of analgesia, 3)Quality of analgesia, 4)Duration of analgesia, 5)Sedation score 6)Side effects. In the postoperative period, intensity of pain was assessed using Linear Visual analog scale.

RESULTS: The statistical study showed no significant difference in the mean arterial blood pressure, mean pulse rate, SPO2 & mean respiratory rate between the 2 groups. Onset the completion of analgesia The mean onset of analgesia was 5–9mins vs (5–10mins; mean 5.95 mins) in both the BB &BF groups. Completion of analgesia occurred earlier in BB group (9–14 min, mean 10.10 mins) & In BF group (9–15mins; mean 10.96 mins). But there was no statistically significant difference between the two groups. Duration of analgesia: The duration of analgesia was longer in butorphanol group which ranged from 5 to 8hours & in fentanyl group it was 3 to 7 hours with a mean of 5.8 hours. This was clinically and statistically significant (p<0.001). Quality of analgesia: The quality of analgesia was good in both BB and BF group. There was no statistical significance between both the groups. Sedation score: The mean value of subjective sedation score was 1.00± 0.06 in group BF and 3.0±0.64in group BB. This was statistical significance (p<0.001). There was no statistically significant difference between the two groups in the incidence of side effects.

CONCLUSION; Epidural butorphanol provides a longer duration of good quality of analgesia with fewer side effects, when compared to epidural fentanyl.