Comparison of Butorphanol and Buprenorphine as an Adjuvant to Local Anaesthesia in Supraclavicular Brachial Plexus Block for Post - Operative Analgesia

BACKGROUND: Supraclavicular brachial plexus block provides anesthesia for surgeries around elbow, forearm and hand. With advent of opioid receptors, variety of opioid agents is used for postoperative analgesia via brachial plexus block. Butorphanol and Buprenorphine can be used along with local anesthetics to provide post op analgesia. AIMS: 1) To study the onset and extent of sensory and motor blockade. 2) To compare the duration of postoperative analgesia in two groups. METHODOLOGY: A study was carried out in 30 patients aged 18-60yr of ASA grade I & II of either sex in each group undergoing orthopedic upper limb surgeries via supraclavicular brachial plexus block. Injection Butorphanol 1mg (Group-I) and Buprenorphine150g (Group-II) were added to local anesthetic mixture. Onset of sensory and motor blockade, extent of blockade and occurrence of any complications were studied in both the groups. All patients were observed for analgesia hourly until patient demanded analgesia post-operatively by VAS pain score. RESULTS: In Group II (Buprenorphine) onset of sensory, motor blockade and complete blockade was delayed as compared to Group I (Butorphanol). In Group I patients, VAS score was 39.44 16.66 at the end of 5 hours while in Group II patients 50.35 25.65 VAS score at the end of 8 hours. So the duration of analgesia was upto 5-6 hours in Group I, where it was upto 8-9 hours in Group II. CONCLUSION: Both drugs are potent analgesic in brachial plexus block, but Buprenorphine is more potent and produces longer duration of postoperative analgesia than Butorphanol.