A Comparative Study Of Intrathecal Hyperbaric 0.5% Bupivacaine Alone Versus Hyperbaric 0.5% Bupivacaine With Butorphanol As An Adjuvant, In Lower Abdominal Surgeries

A Comparative Study Of Intrathecal Hyperbaric 0.5% Bupivacaine Alone Versus Hyperbaric 0.5% Bupivacaine

Abstract

Background: The use of spinal opiates along with intrathecal hyperbaric injection Bupivacaine has become increasingly popular as they potentiate the effect of local anaesthetic agent and improve the quality of analgesia and minimize the requirement of postoperative analgesia. Aim: The aim of this study was to evaluate and compare- Block characteristics, hemodynamics, post operative analgesic efficacy & occurrence of adverse effects. Methods: After approval from institutional ethic committee and informed written consent from patients, this prospective randomised double blind study was conducted on 120 healthy adult patients of ASA status 1 and 2, undergoing intrathecal anaesthesia for lower abdominal surgeries. The patients were randomly assigned into two groups including 60 patients in each group, using “closed envelope methodâ€. Group A (n=60) received- Hyperbaric 0.5% Bupivacaine 3.5ml + 0.5 ml of Normal saline (total volume 4 ml). Group B (n=60) received -Hyperbaric 0.5% Bupivacaine 3.5ml + 0.5ml(0.5 mg) of Butorphanol (total volume 4 ml) was given. Results: Time of onset of sensory block at T8 & onset of motor block was rapid in group B as compared to group A. Mean duration of request for analgesia was 214.66 ±23.52 min in group A and 350.00 ± 29.05 in group B, which was highly significant statistically (p<0.001).Mean duration for sensory regression to L5 was 232.75 ± 20.59 min in group A and 366.66 ± 32.85 min in group B (p<0.001). Fall in systolic & diastolic blood pressure and heart rate was more in group B as compared to group A, but it was clinically and statistically not significant. Conclusion: it may be concluded that 0.5mg of intrathecal butorphanol is a good adjunct in spinal anaesthesia, providing good and prolonged post-operative analgesia with minimal side effects.