Abstract

RANDOMIZED COMPARATIVE STUDY OF THE EFFICACY AND SAFETY OF EPIDURAL BUTORPHANOL VERSUS INTRAMUSCULAR BUTARPHANOL FOR POSTOPERATIVE ANALGESIA IN PATIENTS UNDERGOING LOWER ABDOMINAL SURGERIES

Rumani Ruku* and Sanam Kassana

ABSTRACT

Background: Regional anesthesia is considered to be the safest and cost-effective method of relieving the postoperative pain. The epidural analgesic technique is known to provide effective pain relief with lesser side effects. The objective of the present study was to compare the efficacy of intramuscular butorphanol (1mg/2mg) with epidural butorphanol (1mg/2mg) as postoperative analgesic in patients undergoing lower abdominal surgeries. Methods: This randomized-controlled study was carried out in Government Medical College, Jammu, for a period of 6 months on 100 patients, with physical status ASA I or ASA II, aged between 20 to 60 years, undergoing lower abdominal surgeries, were included. Patients were randomized to receive intramuscularly (n = 50) or EP (n = 50) injections of butorphanol. 25 patients each in IM group and EP group received either 1 mg or 2 mg of butorphanol. Results: MAP was significantly lower in the EP group (p<0.05). Difference in onset of analgesia was significantly lower for epidural dose of 2 mg (p= 0.018). The duration of analgesia was significantly higher in case of EP drug administered at 2 mg (p= 0.009). The Quality of Analgesia was also significantly better for EP drug doses (p = 0.021). Even the incidence of all adverse events was found to be more with IM butorphanol (p < 0.0001). Conclusion: Intramuscular butorphanol was found as effective as an EP dose for the management of postoperative pain. A dose of 2 mg, vide epidural route, gave a faster onset and a longer duration of anesthesia.

Keywords: Postoperative Analgesia, Epidural, Intramuscular, Butorphanol.