Background: International association for the study of pain (IASP) defines pain as “an unpleasant sensory and emotional experience, associated with actual or potential tissue damage or described in terms of such damage”. Effective pain control is essential for optimal care of surgical patients.  Unrelieved pain causes reduction in vital capacity, FRC, tidal volume, all of which lead to hypoxemia, hypercarbia, retention of secretions atelectasis and pneumonia. Postoperative pain can be relieved by using different drugs & different techniques. Epidural analgesia has revolutionized postoperative pain management. aim of the study was to compare the duration of postoperative analgesia for lower abdomen surgeries and other effects produced by epidural injection of  0.25% plain bupivacaine versus 0.25% bupivacaine-butorphanol 2mg, versus 0.25% bupivacaine- fentanyl 50mcg.

Methods: The patients were posted to undergo surgery at SAT hospital medical college Trivandrum during 2012-2014. The study was approved by hospital ethics committee. Seventy-five patients undergoing lower abdominal surgeries were randomly selected for this study. Patients were those undergoing elective surgery that could be performed under lumbar epidural anesthesia ASA physical status grade I and II patients of female sex between 35-60 yrs of age and body weight -ranging from 45- 70 Kg.

Results: The patients were selected at random to avoid any kind of bias and to allow comparability of results obtained in three groups. The three groups were comparable with regards to mean age and weight and sex distribution.The mean onset of time of pain relief in bupivacaine (group I), bupivacaine butorphanol combination (group II) and bupivacaine fentanyl combination (group III) had been 16.92 ± 1.35, 10.98 ± 1.38, 13.24 ± 1.02 minutes respectively. There is highly significant difference among the three groups (P value os 0.000). Bupivacaine butorphanol combination has a faster onset time compared other groups.

Conclusions: butorphanol given along with 0.25% bupivacaine epidurally for lower abdominal surgeries is a safe and effective analgesic for postoperative pain relief, when compared with 0.25% bupivacaine alone and 25% bupivacaine with fentanyl. The addition of epidural butorphanol to 0.25% bupivacaine cause significantly effective analgesia for a prolonged period

Keywords: Bupivacaine, Butorphanol, Epidural Analgesia,Fentanyl, postoperative pain relief.

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Jamuna Rani J

Assistant Professor, Department of Anaesthesia

Government Medical College, Thiruvananthapuram, Kerala, India 695011

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., phone: 919961401288