Key result
Epidural tramadol provided a significantly longer duration of analgesia than butorphanol (6.25 vs 5.35 hours), though butorphanol yielded lower pain scores and higher patient satisfaction.
Why the study?
Does epidural butorphanol improve postoperative analgesia compared to epidural tramadol in patients undergoing lower limb surgery?
RCT (n=60)
Double-blind
randomized
Does epidural butorphanol improve postoperative analgesia compared to epidural tramadol in patients undergoing lower limb surgery?
Absolute Event Rate: 5.35% vs 6.25%
Epidural butorphanol provides better quality of analgesia and patient satisfaction compared to tramadol for postoperative pain relief in lower limb surgeries.
May offer better analgesia quality with butorphanol than tramadol; leaves open optimal choice pending larger trials.
BACKGROUND: Post operative analgesia in patients undergoing lower limb surgery is very essential for immediate postoperative pain relief which can be provided by oral or parentral medication, epidural analgesia, local blocks etc.The study was designed to evaluate the efficacy of epidural butorphanol and tramadol for postoperative pain relief. PATIENTS #ENTITYSTARTX00026; METHODS: This was randomized, prospective, double blind study was conducted on 60 patients, ASA grade I&II, age 18-60 undergoing lower limb surgeries after approval from hospital ethics committee. Group allocation - Group I I (n=30) received 2 mg butorphanol as bolus epidurally, 1 mg for top up dose. Group II (n=30) received 100mg tramadol as bolus, 50 mg for top up. All the drugs were diluted to 10 ml normal saline & the observer was blinded to the drugs given. Postoperatively VAS, sedation score, vitals & side effects were observed. Top ups were given on achieving VAS>4. Diclofenac 75mg was given as rescue analgesia. RESULTS: Duration of analgesia was 5.35±0.29 hr and 6.25±1.58 hrs in Butorphanol and Tramadol groups respectively and the difference was found to be statistically significant. Pain scores were also significantly lower statistically in Group I as compared to Group II. Sedation scores were significantly higher in butorphanol group, whereas nausea vomiting was seen in tramadol group only (4 patients).No other side effects were observed. CONCLUSIONS: Both butorphanol and tramadol were effective for relieving postoperative pain, however quality of analgesia & patient satisfaction was more with butorphanol.
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Gupta et al. (2011) conducted an RCT in Postoperative pain (n=60). Epidural butorphanol vs. Epidural tramadol was evaluated on Duration of analgesia. Epidural tramadol provided a significantly longer duration of analgesia than butorphanol (6.25 vs 5.35 hours), though butorphanol yielded lower pain scores and higher patient satisfaction.
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