Title: Intrathecal Butorphanol: An Effective Option for Post Operative Pain Relief in Caesarean Patients
Authors: Swetha Purohit MD (Anaesthesia), Ramachandra Badami DNB (Orthopaedics)
DOI: https://dx.doi.org/10.18535/jmscr/v5i12.155
Abstract
Introduction: A pain free post-operative period is a boon to mother for caring the neonate .Spinal anesthesia is most preferred technique for caesarean section. Spinal opiates as adjuvants potentiate effect of local anesthetics and give prolonged postoperative analgesia.
We evaluated the effect of addition of 25 mcg of injection butorphanol to hyperbaric injection bupivacaine 0.5% on hemodynamic changes neonatal outcome and post-operative analgesia in patients undergoing elective lower segment caesarean section (LSCS).
Methodology: After obtaining ethical committee clearance and patient consent a double blinded prospective RCT was conducted between July2016- Feb2017. 60 ASA grade-I and II patients were divided into two equal groups. Group A(n=30) patients received injection hyperbaric bupivacaine 0.5%1.8 ml + injection butorphanol 25 mcg in 0.5 ml normal saline (NS) and Group B (n=30) received injection hyperbaric bupivacaine 0.5%1.8 ml + 0.5ml NS making total volume 2.3 ml by intrathecal route .
The principle outcome measures were onset, duration of sensory and motor block, hemodynamics, apgar scores and duration of postoperative analgesia. Study groups were analysed using chi-square test. P-Value by SPSS software.
Results: Duration of analgesia was significantly better in group A (264.16 min vs 141.36min) Hemodynamics and Apgar scores showed no statistical significance in both groups.
Conclusion: Intrathecal butorphanol gives longer duration of post-operative analgesia without compromising neonatal scores and maternal hemodynamics.
Keywords: Bupivacaine, Butorphanol, Caesarean ,Spinal.
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