A COMPARATIVE STUDY OF EPIDURAL BUTORPHANOL AND TRAMADOL FOR POSTOPERATIVE ANALGESIA IN ORTHOPEDIC LOWER LIMB SURGERIES
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Author:
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, KIRAN A V, SUNIL B.VASUDEVARAO, RAGHAVENDRA B GOUDER
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Abstract:
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Post operative pain management is a challenge in anaesthesia practice. Many opioids are available for epidural use with
various side effects. The main objectives of the study is to asses and compare the postoperative analgesia and quality
of analgesia with epidural butorphanol or tramadol in patients undergoing orthopaedic lower limb surgeries. 100
patients of either sex, belonging to 20-60 yrs of age, ASA grade I and II admitted for orthopedic lower limb surgeries
were included in the study. In the post-operative period when the patients visual analogue score >4 received either
1 mg of butorphanol (group B) or 50 mg of tramadol (group T) diluted to 10 ml with normal saline. We monitored
and compared the Onset ,Duration , Quality of analgesia, consciousness, Cardio-respiratory and Side effects. the
mean time of onset of analgesia in group-T was 13.28±2.04 min and in group-B was 11.20±1.02 min, which is
statistically significant(p<0.01). The duration of action of analgesia in group-T was 369.8±25.6 min and in group-B was
215.2±26.0 min which is Statistically significant as ‘p’ value is <0.01. Quality of Analgesia (VRS) was better with
butorphanol group. The Quality of Analgesia (VRS) in group-T was 3.22±0.54 (SD) min and in group-B was 3.62±0.49
(SD) min (p<0.01) which is statistically significant. Sedation Score was significantly higher with butorphanol group at
first hour(P<0.01). Tramadol group had significantly higher incidence of nausea and vomiting(P,0.01). In conclusion
epidural butorphanol is better then epidural tramadol for post-operative analgesia. Epidural butorphanol produces
faster onset of analgesia , but the duration of analgesia is lesser when compared to tramadol . Side effects like nausea
and vomiting are less in butorphanal group but sedation score was higher. Patient satisfaction was better in
butorphanol group.
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Keyword:
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butorphanol, tramadol, epidural analgesia, post operative pain, lower limb surgeries
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EOI:
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DOI:
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