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Indian Journal of Anesthesia and Analgesia

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Comparative Study of Epidural Butorphanol & Epidural Fentanyl for the Relief of Post Operative Pain in Lower Abdominal & Lower Limb Surgery

Ushma D. Shah* , Ushma D. Shah* , Krunal N. Dudhwala* , Mukesh S. Vakil**

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Indian Journal of Anesthesia and Analgesia 4(2):p 229-233, April - June 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4217.9

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Abstract

 Background and Aim: Post operative pain relief is an essential part of responsibility for an anaesthesiologist. Epidural opioids acting through the spinal cord receptors improve the quality and duration of analgesia. The present study compared the efficacy and safety profile of epidurally administered butorphenol and fentanyl. Methods: In this double blinded study, 60 patients undergoing lower abdominal and lower limb surgery were randomly divided into two groups by computer generated random number. In all patients, epidural space is located at L2­ L3 space using 18G Tuohy needle with loss of resistance technique.20G catheter passed through needle till about 2­3cm of catheter was in space. Test dose was injected. After 5 min, induction was done with spinal anaesthesia with inj. Bupivacaine heavy 0.5% 3cc at same lumber space in sitting position. Group A patients received epidural Butorphenol 1mg diluted in 10ml Ns as first dose post op when VAS>5 and top up dose 0.5 mg diluted in 10ml NS when VAS>5. Group B patients received epidural fentanyl 100microgram diluted in 10ml NS as first dose post op when VAS>5 and top up dose fentanyl 50microgram diluted in 10ml NS when VAS>5.Vital parameter, onset, duration, quality of analgesia, side effects, VAS score, sedation score were observed. The data was collected and tabulation formed and statistical analysis of continuous data was done by unpaired student “t” test and chi­square test was applied for discrete data. Results were considered statistically significant with p value <0.05 and highly significant with p value <0.001. Results: Demographic profiles of patients were comparable in both the groups. Onset of analgesia was earlier in fentanyl group than butorphenol group. Butorphenol provides longer duration of analgesia compared to fentanyl group. Quality of analgesia was better with butorphanol than fentanyl. Conclusion: Butorphanol and fentanyl both drugs are safe to provide analgesia via epidural route in post operative period without significant side effects. Fentanyl is having earlier onset with short duration of analgesia while butorphanol provide analgesia for longer duration with delayed onset.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4217.9

Keywords

Butorphenol; Fentanyl; Lower Abdominal and Lower Limb Surgeries; Lumber Epidural Anaesthesia; Post Operative Pain Relief.

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