Comparison of Two Different Doses of Butorphanol for Post Operative Analgesia in Totalabdominal Hysterectomies.

INTRODUCTION Postoperative pain especially in abdominal surgeries is an important reason for increased morbidity, prolonged hospital admission and patient dissatisfaction. Epidural analgesia with opioids has advantage over systemic opioids by providing adequate analgesia with lesser doses and less incidence of cardiovascular, respiratory or thromboembolic complications. AIMS This study was done to compare effectiveness of two different doses of butorphanol when used epidurally for postoperative analgesia. Safety and side effect prole was also compared. MATERIALS AND METHODS This prospective, randomized controlled, double-blinded study was carried out at a tertiary care hospital. 60 patients belonging to ASA I, II aged between 30 to 60 years scheduled for total abdominal hysterectomy under General Anaesthesia were enrolled for the study into two groups Aand B. Group Apatients received epidural butorphanol 1mg diluted till 10ml in normal saline (NS) while as Group B patients received epidural butorphanol 2mg diluted till 10 ml of NS. Observed parameters were changes in vital parameters like heart rate, respiratory rate and systolic blood pressure. The time taken for onset, peak effect and duration of analgesia was compared between the two groups. Mean pain scores at different time intervals were recorded and compared, side effects if seen were noted. RESULTS Onset of analgesia was similar in group A (17.83 + 5.97 min) when compared with group B (17.83 + 2.62 min). Peak onset of analgesia was achieved signicantly earlier in group B (43.17+ 5.72 min) than in group A (54.83 + 19.02). Duration of analgesia was also signicantly longer in group B (317.6 + 38.86 min) than in Group A(266.3 + 101.15 min). Mean pain scores when compared over the time until weaning showed that pain scores were signicantly lower at30 min to 1 hour interval. Side effects like sedation and nausea/vomiting was seen more in group B patient. CONCLUSION Epidural butorphanol 2mg is an effective dose for postoperative analgesia for abdominal surgery like total abdominal hysterectomy and provides good analgesia with early peak and prolonged action.