Comparison Among Intrathecal Fentanyl And Butorphanol As An Adjuvant To Hyperbaric Bupivacaine For Lower Limb Orthopaedic Procedures

Indian Journal of Applied Basic Medical Sciences
Year: 2021, Volume: 23(A), Issue. (1)
First page: (316) Last page: (327)
Online ISSN: 2249-7935
Print ISSN: 0975-8917
doi: 10.48165/ijabms.2021.23125

Comparison Among Intrathecal Fentanyl And Butorphanol As An Adjuvant To Hyperbaric Bupivacaine For Lower Limb Orthopaedic Procedures

Harshil kumar Kamleshkumar Chavda1, Jyotsana Sirohi2*, Srushti Rakeshbhai Shah3 and Gargi M bhavsar4
1Ex anesthesia resident, 2 3rdyear resident, 3 1st year resident, 4Ex-Assistant Professor, Smt. NHL Medical College, Ahmedabad. Presently Senior Resident, Anaesthesia department, ND Desai Medical College, Nadiad
Corresponding Author: Jyotsana Sirohi, Email:dr.jyotsanasirohi@gmail.com

Online Published on 02-February-2021

ABSTRACT

AIMS & OBJECTIVES The study was conducted to compare the effect of

  • Bupivacaine Heavy 0.5% 3 ml with fentanyl (25 mcg) 0.5 ml.
  • Bupivacaine Heavy 0.5% 3 ml with Butorphanol (25 mcg) 0.5 ml
  • When administered intrathecally for lower limb orthopedic procedures.MATERIAL AND METHODSAfter obtaining a written and informed consent a comparative study of 60 patients. Patients were randomly divided in two groups of 30 each. Group BB (Butorphanol group) received 25 mcg Butorphanol with 15 mg hyperbaric Bupivacaine (0.5%; 3.0 ml) Group BF (Fentanyl Group) received 25 mcg fentanyl with 15 mg hyperbaric Bupivacaine (0.5%, 3.0 ml).BACKGROUND
  • Amongst the drugs used for spinal anesthesia Bupivacaine is still considered as the standard drug. Combining opioids with local anesthetics has got a synergestic effect, improving intra & postoperative analgesia. Combination of these agents reduces side effects caused by either of them.
  • We therefore conducted this study to evaluate the efficacy of Butorphanol & Fentanyl as adjuvant to Bupivacaine in lower limb orthopedic surgeries.
  • OBSERVATION AND RESULTS
  • When Fentanyl and Butorphanol are used as an adjuvant to hyperbaric Bupivacaine for spinal anesthesia, Butorphanol provides longer duration of sensory & motor block compared to Fentanyl.
  • Duration of analgesia was also longer with Butorphanol which delayed the time for 1st analgesic request compared to fentanyl.
  • No significant haemodynamic changes or adverse effects were noted with either adjuvant.
  • CONCLUSIONThough Butorphanol intrathecally did not enhance the degree of sensory or motor block, its prolonged duration of Bupivacaine induced sensory block & reduced analgesic requirement during early post op period, with good hemodynamic stability without any adverse effects.

Keywords

Intrathecal Bupivacaine Heavy, Fentanyl, Butorphanol, Spinal Anaesthesia

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