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Indian Journal of Anesthesia and Analgesia

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Comparative Study of Epidural Bupivacaine with Butorphanol and Bupivacaine with Tramadol for Postoperative Pain Relief in InfraUmblical Surgeries

Bhardwaj Amit* , Bhardwaj Amit* , Singh A.P.** , Anand Asha*

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Indian Journal of Anesthesia and Analgesia 4(2):p 241-245, April - June 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4217.12

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Abstract

 Introduction: To compare the efficacy of combination of epidural local anesthetic with tramadol and butorphanol in infra­umblical surgeries. Aims and Objectives: To evaluate duration of analgesia, analgesic efficacy, and safety profile of two groups of drugs­epidural butorphanol with bupivacaine and epidural tramadol with bupivacaine. Material and Methods: A prospective, randomized controlled, doubleblinded study was undertaken in 60 patients scheduled for infra­umblical surgeries. Group I received epidural butorphanol 2 mg + bupivacaine 0.125% as first dose and subsequent doses, butorphanol 1 mg + bupivacaine 0.125% (total volume 10 ml). Group II received epidural tramadol 2 mg/kg + bupivacaine 0.125% as first dose and subsequent doses, tramadol 1 mg/kg + bupivacaine 0.125% (total volume 10 ml). Observed parameters were the quality of analgesia, sedation, and hemodynamic parameters in the intra and post­operative period. Time for request of rescue analgesia was noted in all the patients. Results: Visual analog scale better with butorphanol group than tramadol at 30 min after first dose. Onset of action faster with butorphanol but duration of analgesia longer with tramadol. Sedation was seen more commonly in patients with butorphanol group where as incidence of nausea and vomiting was hign in tramadol group. Conclusion: Epidural butorphanol has better quality of post­operative pain relief but the reduced duration of analgesia and sedation are the limiting factors. Epidural tramadol along with antiemetic administration is prefered for bariatric, geriatric patients, ambulatory surgeries and in patients with compromised respiratory system where sedation can be disastrous.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4217.12

Keywords

Butorphanol; Epidural; Tramadol.

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