IJSR International Journal of Scientific Research 2277 - 8179 Indian Society for Health and Advanced Research ijsr-7-5-15333 Original Research Paper A prospective, randomized, controlled, triple-blinded, single centre trialevaluating the postoperative analgesic effect of Butorphanol as adjuvant to 0.25% Bupivacaine compared to 0.25% Bupivacaine alone in Caudal Epidural in adult patients undergoing single-level Lumbar Disc Surgeries Hitesh Chand Sharma Dr. Dr. Padma S. Dr. May 2018 7 5 01 02 ABSTRACT

 Introduction– Patients undergoing Lumbar Laminectomy experience severe postoperative pain increasing morbidity. Optimal pre–emptive pain

relief hastens rehabilitation, and decreases incidence of chronic pain. Prone position and fluoroscopy guidance used for Spine surgeries is ideal for
the application of caudal epidural block. Use of Butorphanol to prolong analgesia in Spine patients is lacking in the literature. Hence, this study was
put into effect.
Methods–After block randomization, 60 ASA grade I and II adult patients were allocated to 2 groups– Group A– received 20 ml of 0.25%
Bupivacaine in the Caudal Epidural Space, Group B– received 20 ml of 0.25% Bupivacaine to which 25 micr/kg of Butorphanol was added in the
Caudal Epidural Space. The primary outcome was to study the postoperative analgesic duration, secondary outcome was comparison of the
perioperative hemodynamics between the two groups.Student t–test (two–tailed, independent), Chi–square/ Fisher Exact Test were used as tests of
significance for intergroup analysis and categorical data respectively.
Results–The mean time for the demand of rescue analgesic was 6.33+–3.09 hrs in Group A vs 11.20 +–4.38 hrs in Group B. The mean total 24 hour
analgesic consumption was 79.0+–20.06 mg in Group A vs 44.0 +–15.22 mg in Group B. The differences were statistically significant. Also, Group
B was hemodynamically more settled compared to Group A in 24 hours postoperatively.
Conclusion–Pre–emptive Butorphanol (25 micr/kg) addition effectively prolongs the analgesic duration of 0.25% Bupivacaine compared to
Bupivacaine alone administered in Caudal epidurals for Single–level Adult Lumbar Spine Surgeries. The combination also gives more
hemodynamic stability for 24 hrs postoperatively.