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Category: Volume 07 Issue 12 December 2019
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Title: A Comparative Study between Epidural Butorphanol, Nalbuphine, and Fentanyl for Post-Operative Analgesia in Lower Abdominal Surgeries: A Prospective Randomised Double Blinded Trial

Authors: Dr Bura Anil Sarath Chandra, Dr B.Vishnu Mahesh Babu

 DOI: https://dx.doi.org/10.18535/jmscr/v7i12.93

Abstract

Background: The popular technique nowadays regarding the management of acute postoperative pain is the use of epidural opioids.

Aim: To assess the postoperative analgesic benefits in patients who administered epidural Fentanyl, Nalbuphine, and Butorphanol as adjuvants with local anaesthetics postoperatively for surgeries done under epidural anaesthesia.

Methods: Total 90 patients were scheduled for surgeries of lower abdomen belonging to age groups 19-65 years were divided randomly into 3 groups of 30 each. For all patients, surgeries were performed by Epidural technique using bupivacaine 0.5%. The study drug was administered through the epidural catheter in the postoperative period. Group F received Fentanyl 100 μg; Group N received nalbuphine 10 mg and Group B received Butorphanol 2 mg along with 0.125% bupivacaine, which was diluted with normal saline to 10 ml each. The onset of action, duration of analgesia, quality of analgesia, hemodynamic changes, and side effects – such as nausea, vomiting, pruritus, sedation, respiratory depression, and urinary retention - were recorded.

Results: In all three groups, the demographic data were readily comparable. When compared to other groups, the onset of sensory blockade was significantly earlier in Group F (Fentanyl). Significantly, longer duration was observed in Group B (Butorphanol). There were no significant haemodynamic side effects observed in any of the groups.

Conclusion:  Onset of analgesia is faster with Fentanyl, but pruritus is the ocassional side effect. Duration of analgesia is significantly prolonged with epidurally administered Butorphanol than that of epidural nalbuphine and epidural Fentanyl.

Keywords: Epidural analgesia, Fentanyl, Nalbuphine, and Butorphanol.

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Corresponding Author

Dr B.Vishnu Mahesh Babu M.D (Anaesthesia)

Associate Professor, Department of Anaesthesia, Rangaraya Medical College, Kakinada (A.P)