A Comparative Study of Epidural Butorphanol and Epidural Morphine for the Relief of Postoperative Pain

Abstract

Epidural administration of various anaelgesics gained increasing popularity following the discovery of opioid receptors in the spinal cord capable of producing potential analgesia. \the analgesic effect seems to be more when epidural anesthesia is continued in the post-operative period as epidural analgesia. It is now clear that epidural administration of opioids relieves patient of extended pain post-operatively. Ours was a comparative study of epidural butorphanal and epidual morphine for the relief of postoperative pain. METHODS: Sixty adult patients in ASA class I and II, weighing 45 to 60kgs of either sex, belonging to 21-60 years of age, posted for elective lower abdominal & lower limb surgeries in orthopaedics, gynaecological, urological, plastic and general surgeries under epidural anaesthesia were selected for the study. The study was undertaken to evaluate the efficacy and safety of epidural butorphanol 2 mg diluted to 10 ml of normal saline in comparison with epidural morphine 2.5 mg diluted to 10 ml of normal saline given for relief of postoperative pain. In the post-operative period the following parameters were studied, 1. Onset of analgesia, 2. Duration of analgesia, 3. Quality of analgesia, 4. Side effects like nausea, vomiting, hypotension, respiratory depression, and pruritus allergic reaction were looked for. RESULTS: Mean onset of analgesia was 14.66+4.34 (S. D) minutes in group-A, and in group-B was 34.76+5.73 (S. D) minutes. The Statistical analysis by Student's unpaired t-test showed that time of onset of analgesia in group-A was significantly less when compared to group-B. (t = 15.29 with df-54,

Postoperative pain relief with epidural buprenorphine versus epidural butorphanol in laparoscopic hysterectomies: A comparative study

“…Duration of analgesia in the morphine group ranged from 10 to 24 h with a mean ± SD of 16.05 ± 3.14 h. The quality of analgesia was comparable in both groups, and the difference is statistically insignificant ( P > 0.05). [ 19 ]…”

A Comparative Study of Epidural Bupivacaine and Epidural Bupivacaine With Lowdose Butorphanol for Perioperative Analgesia in Patients Undergoing Elective Gynaecological Surgeries

“…In a previous study, Malik P et al 29 also report that butorphanol provides a longer duration of analgesia, but more sedation compared with fentanyl while increased incidence of nausea and pruritus is associated with the use of the latter. Devulapalli P K, et al 30 recently reported that epidural butorphanol has faster onset of action compared with epidural morphine (14.66 vs 34.76 mins, respectively).…”

Advances in the Use of Butorphanol Tartrate in Postoperative Analgesia after Cesarean Section

“…Compared with intermittent parenteral application of opioids, epidural administration acts on specific opioid receptors that are abundantly distributed in the posterior horn of the spinal cord, resulting in a more rapid onset of analgesic action and a lower incidence of adverse effects such as nausea, vomiting, and pruritus [28] . Due to its high lipid solubility, bupropion tartrate diffuses in the spinal cord after epidural administration, reducing the transfer of residual drug in the cerebrospinal fluid from the lumbar region to the brainstem, avoiding inhibition of the medullary respiratory centre and reducing the incidence of respiratory depression [29] .…”