Abstract

Postoperative pain is a typical example of acute pain. Several inflammatory, visceral, neuropathic pain mechanism account for pain in postoperative period. More than 80 millions of patients undergo surgeries which is associated with considerable post operative discomfort. To assess the analgesic effectiveness of epidural butorphanol and epidural tramadol for postoperative pain relief in lower limb surgeries and duration of analgesia, this study was done with a profile of 60 patients of ASA physical status I and II, aged between 18 to 65 years, belonging to both genders undergoing routine orthopedic lower limb surgeries under combined spinal epidural anaesthesia were enrolled in the study, after getting approval from Institutional Ethical Committee and written informed consent from the patients was taken. These patients were assigned to one of the groups for statistical purpose into group B and group T. Every alternate patient received injection butorphanol or injection tramadol epidurally in the post operative period when the VAS score for pain crossed scale of 4. The parameters observed were intensity of pain using Visual analogue scale, sedation scores, duration of analgesia, number of epidural top ups required, hemodynamic parameters and any adverse effects up to 24 hours postoperatively. In our observation, we found that the patients in the tramadol group (group T) experienced longer duration of analgesia 7.4 ± 2.58 hours as compared to butorphanol group where duration of analgesia was 5.7 ± 0.758 hours with a significant p value of 0.002. Tramadol group patients required lesser number of epidural top ups. The total drug consumption in the post operative period was lesser in group T as compared to group B which was statistically significant (p value 0.001). The VAS scores of the two groups noted in the post operative period showed a statistically significant difference with lower VAS scores in the butorphanol group as compared to tramadol group indicating better pain relief with epidural butorphanol. The sedation scores were also compared between the two groups in the post operative period where higher sedation scores were obtained for butorphanol group as compared to tramadol group.

Description