Published October 31, 2022 | Version https://impactfactor.org/PDF/IJPCR/14/IJPCR,Vol14,Issue10,Article92.pdf
Journal article Open

Comparative Study of Epidural Bupivacaine with Buprenorphine, Pentazocine and Tramadol for Post Operative Pain Relief

  • 1. Assistant Professor, Department of Anesthesia, GMC, Datia
  • 2. Assistant Professor, Department of Anatomy, MLB Medical College, Jhansi

Description

Introduction: Pain is also old as evolution of life. All the definition of pain seems to be incomplete it cannot be defined completely. It is subjective sensation which varies individual. To make whole world pain free, medical research is continuing. Objectives: To evaluate duration of analgesia, analgesic efficacy, and safety profile of two groups of drugs-epidural butorphanol with bupivacaine and epidural tramadol with bupivacaine. Materials and Methods: A prospective, randomized controlled, double-blinded study was undertaken in 100 patients scheduled for major abdominal surgeries. Group B received epidural bupronorphine .3 mg + bupivacaine 0.125% first dose and subsequent doses, butorphanol 1 mg + bupivacaine 0.125% (total volume 10 ml). Group T received epidural tramadol 2 mg/kg + bupivacaine 0.125% first dose and subsequent doses, tramadol 1 mg/kg + bupivacaine 0.125% (total volume 10 ml). Results: Visual analog scale better with bupronorphine group than tramadol (0.12 ± 0.332 and 0.84 ± 0.746 for Group B and Group T) at 30 min after first dose. Onset of action (8.44 ± 1.158 min in Group B and 12.80 ± 1.354 min in Group T) faster with butorphanol but duration of analgesia longer with tramadol (5.92 ± 0.76 h in Group B vs. 7.68 ± 0.76 h in Group T). Sedation was seen in patients with butorphanol group. Nausea and vomiting more frequent with tramadol group. Conclusions: Epidural tramadol with antiemetic is better than buprenorphine and pentazocine for its longer duration in ambulatory surgery, elderly patients, obese patients, and suitable high-risk patients.

 

 

 

Abstract (English)

Introduction: Pain is also old as evolution of life. All the definition of pain seems to be incomplete it cannot be defined completely. It is subjective sensation which varies individual. To make whole world pain free, medical research is continuing. Objectives: To evaluate duration of analgesia, analgesic efficacy, and safety profile of two groups of drugs-epidural butorphanol with bupivacaine and epidural tramadol with bupivacaine. Materials and Methods: A prospective, randomized controlled, double-blinded study was undertaken in 100 patients scheduled for major abdominal surgeries. Group B received epidural bupronorphine .3 mg + bupivacaine 0.125% first dose and subsequent doses, butorphanol 1 mg + bupivacaine 0.125% (total volume 10 ml). Group T received epidural tramadol 2 mg/kg + bupivacaine 0.125% first dose and subsequent doses, tramadol 1 mg/kg + bupivacaine 0.125% (total volume 10 ml). Results: Visual analog scale better with bupronorphine group than tramadol (0.12 ± 0.332 and 0.84 ± 0.746 for Group B and Group T) at 30 min after first dose. Onset of action (8.44 ± 1.158 min in Group B and 12.80 ± 1.354 min in Group T) faster with butorphanol but duration of analgesia longer with tramadol (5.92 ± 0.76 h in Group B vs. 7.68 ± 0.76 h in Group T). Sedation was seen in patients with butorphanol group. Nausea and vomiting more frequent with tramadol group. Conclusions: Epidural tramadol with antiemetic is better than buprenorphine and pentazocine for its longer duration in ambulatory surgery, elderly patients, obese patients, and suitable high-risk patients.

 

 

 

Files

IJPCR,Vol14,Issue10,Article92.pdf

Files (323.2 kB)

Name Size Download all
md5:eaead814db4687d7ec08e3e6fd9be06c
323.2 kB Preview Download

Additional details

Dates

Accepted
2022-10-15

References

  • 1. Dhimar AA, Patel MG, Swadia VN, Desai DJ. Epidural butorphanol: comparison of two different doses for lower limb orthopaedic surgery. J Anaesth Clin Pharmacol 2006;22(1):47- 52. 2. Jasleen Kaur, Sukhminder Jit Singh Bajwa. Comparison of epidural butorphanol and fentanyl as adjuvants in the lower abdominal surgery: a randomized clinical study. Saudi J Anesthesia 2014;8(2):167-71. 3. Singh Bhagwat, Nihlani Sanjay. Postoperative analgesia: a comparative study of epidural Butorphanol and epidural Tramadol. J Adv Res Biol Sci 2011;3(2):86-9. 4. Bromage PR, Camporesi E, Chestnut D. Epidural narcotics for postoperative analgesia. Anesth Analg 1980;59:473-80. 5. Reiz S, Westberg M. Side-effects of epidural morphine. Lancet 1980;2(8187):203-4. 6. Ruchi Gupta, Simmerpreet Kaur, Saru Singh, KS Aujla. A comparison of epidural butorphanol and tramadol for postoperative analgesia using CSEA technique. J Anaesth Clin Pharmacol 2011;27(1):35-8. 7. Bharti N, Chari P. Epidural butorphanolbupivacaine analgesia for postoperative pain relief after abdominal hysterectomy. J Clin Anesth 2009;21:19-22. 8. Shrestha CK, Sharma KR, Shrestha RR. Comparative study of epidural administration of 10 ml of 0.1% bupivacaine with 2mg butorphanol and 10 ml of 0.25% plain bupivacaine for analgesia during labor. JNMA J Nepal Med Assoc 2007;46:1-6. 9. Tan PH, Chou AK, Perng JS, Chung HC, Lee CC, Mok MS. Comparison of epidural butorphanol plus clonidine with butorphanol alone for postoperative pain relief. Acta Anaesthesiol Sin 1997;35:91- 6. 10. Pokharel K1, Rahman TR, Singh SN, Bhattarai B, Basnet N, Khaniya S. The efficacy and safety of low dose epidural butorphanol on postoperative analgesia following cesarean delivery. JNMA J Nepal Med Association 2008;47(170):57-61. 11. Hunt CO, Naulty JS, Malinow AM, Datta S, Ostheimer GW. Epidural butorphanolbupivacaine for analgesia during labor and delivery. Anesth Analg 1989;68:323- 7. 12. Ackerman WE, Juneja MM, Kaczorowski DM, Colclough GW. A comparison of the incidence of pruritus following epidural opioid administration in the parturient. Can J Anesth 1989;36:388-91.