Comparative Evaluation of Butorphanol Versus Nalbuphine for Postoperative Epidural Analgesia in Lower Limb Orthopaedic Surgeries

Kumar, Mukesh; Lal, A; Kaur, Haramritpal; Singh, Gurpreet; Baghla, Naresh; Jhand, Harmanpreet Kaur

doi:10.21088/ijaa.2349.8471.6219.37

Cited by 2 publications

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“…S Manojprabhakar, M Dhakshinamoorthy et al 10 found that epidural nalbuphine 10 mg with 0.125% bupivacaine provided longer duration of analgesia compared to 100 mcg fentanyl with 0.125% bupivacaine both diluted to 10 ml with normal saline was similar to our results. Hala Mostafa Gomaa et al 11 found that an intrathecal adjuvant of nalbuphine 0.8mg to hyperbaric bupivacaine for cesarean delivery intensified postoperative analgesia more as compared to fentanyl 25µgm and hyperbaric bupivacaine mixture and this was in line with our observations. In a 2017 Swarna Banerjee et al 12 concluded that addition of nalbuphine 10 mg to 0.125% hyperbaric bupivacaine prolonged duration of postop analgesia compared to 100mcg fentanyl with 0.125% bupivacaine which was consistent with our study.…”

Section: Complicationssupporting

confidence: 91%

“…9 Manoj Prabhakar et al, 10 in a randomized double-blind study compared the post-operative analgesia, hemodynamic variations, and side effects of epidural administration of nalbuphine versus fentanyl as an adjuvant to bupivacaine in elective lower limb surgeries and found that the mean duration of analgesia was longer in nalbuphine group (387.83±38.32 min) compared to fentanyl group (343.60±25.64 min). Kumar et al, 11 compared epidural butorphanol versus nalbuphine as an adjuvant to ropivacaine in 60 adult patients in lower limb orthopedic surgeries under combined spinal epidural anesthesia and found that the onset of analgesia was earlier in nalbuphine group (1.45±0.51 min) followed by butorphanol group (4.45±0.61 min) and the duration of analgesia was significantly prolonged in nalbuphine group (6.40±0.821 h) than butorphanol group (4.45±0.605 h). Shelke et al, 12 in a randomized prospective double-blind study involving 40 patients compared epidural nalbuphine or fentanyl to 2% ropivacaine and found that the pain score was comparable in both the groups, but the number of rescue analgesics requirement was higher in nalbuphine group than fentanyl group.…”

Section: Introductionmentioning

confidence: 99%

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A randomized comparative study of epidural ropivacaine 0.2% with adjuvant fentanyl or nalbuphine for post-operative analgesia in lower limb surgeries

Harichandan,

Khuntia,

Sahu

et al. 2024

Asian J Med Sci

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Background: Opioid analgesics with local anesthetics in an epidural route are extremely safe, effective, and reliable methods of post-operative pain relief. Aims and Objectives: The primary objective is to compare the duration of analgesia and pain scoring by visual analog scale. The secondary objective is to monitor sedation, hemodynamic changes, and side effects such as nausea, vomiting, shivering, and pruritus. Materials and Methods: A prospective randomized comparative study of 0.2% ropivacaine with nalbuphine and 0.2% ropivacaine with fentanyl in epidural route for post-operative analgesia in elective lower limb surgeries under spinal anesthesia was carried out in a population of 80 patients. After 1½ h of surgery under spinal anesthesia, patients in group RF received 10 mL of 0.2% ropivacaine with 25 mcg of fentanyl and those in group RN received 10 mL of 0.2% ropivacaine with 2.5 mg of nalbuphine and were observed for the study parameters over time. Results: The mean duration of analgesia was longer in group RN than in group RF (398.45 vs. 222.88 min). The hemodynamic parameters such as heart rate, mean arterial pressure, and respiratory ratewere statistically significant from 240 to 480 min which is 4–6 h in group RF and 6–8 h in group RN. 27.5% of patients in group RN attained sedation whereas 7.5% of subjects in group RF had a sedation score of 2 and above at 30 min. The subjects in group RN had a lower visual analog score than group RF. 12% and 4% of patients had vomiting in group RN and group RF, respectively. Conclusion: Epidural nalbuphine in a dose of 2.5 mg with 0.2% ropivacaine provided a longer duration of analgesia with better pain score and more sedation which was advantageous for post-operative patient compliance and satisfaction as compared to 25 mcg of fentanyl with 0.2% ropivacaine.

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Section: Complicationssupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

A randomized comparative study of epidural ropivacaine 0.2% with adjuvant fentanyl or nalbuphine for post-operative analgesia in lower limb surgeries

Harichandan,

Khuntia,

Sahu

et al. 2024

Asian J Med Sci

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“…The duration of analgesia was also longer in the buprenorphine group than in the butorphanol group (566.17 ± 73.14 vs. 325 ± 47.42, P < 0.001); nevertheless, side effects were more in the buprenorphine group (16). Another study conducted by Kumar and Kaladhar demonstrated that the onset of analgesia was faster in the butorphanol group than in the buprenorphine group; however, analgesia duration was longer in the buprenorphine group (17). Various studies have demonstrated that buprenorphine is effective as an analgesic for postoperative pain (18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Epidural Bupivacaine and Buprenorphine to Bupivacaine and Butorphanol for Postoperative Analgesia in Lower Limb Orthopedic Surgery

Savitha

et al. 2023

Anesth Pain Med

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Background: Postoperative analgesia is of utmost importance in the treatment of patients undergoing surgery. Good postoperative pain management reduces hospital stay and improves early ambulation. This study compared the efficacy of epidural bupivacaine with buprenorphine to butorphanol in lower limb orthopedic surgery. Objectives: This study was carried out to investigate the onset of analgesia, the extent of analgesia, sedation score, and side effects of butorphanol with bupivacaine versus buprenorphine with bupivacaine. Methods: In a clinical trial study, 100 patients who underwent elective orthopedic lower limb surgery were randomly allocated to two groups. A total of 100 patients with American Society of anesthesiologists grades I and II posted for lower limb orthopedic surgery were enrolled in this randomized, double-blind study. The patients were divided into groups A and B. Subarachnoid block was achieved with 3.4 mL of 0.5% bupivacaine. The pain was monitored by the visual analog scale postoperatively. The patients in group A received bupivacaine with buprenorphine, and group B received bupivacaine with butorphanol when they complained of pain in the postoperative period. The onset of analgesia, duration of analgesia, sedation score, and side effects were compared between the two groups. Results: The onset of analgesia was observed earlier in group A than in group B (7.7 ± 1.6 vs. 12.6 ± 1.7 minutes, P < 0.001). The duration of analgesia was longer in group A than in group B (590 ± 40 vs. 480 ± 54 minutes, P < 0.001). Pulse rates and mean arterial pressures were significantly different (P < 0.001). Side effects were common in both groups. Conclusions: Buprenorphine added to bupivacaine provides earlier onset and longer postoperative epidural analgesia than epidural butorphanol with bupivacaine.

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Comparative Evaluation of Butorphanol Versus Nalbuphine for Postoperative Epidural Analgesia in Lower Limb Orthopaedic Surgeries

Cited by 2 publications

References 0 publications

A randomized comparative study of epidural ropivacaine 0.2% with adjuvant fentanyl or nalbuphine for post-operative analgesia in lower limb surgeries

A randomized comparative study of epidural ropivacaine 0.2% with adjuvant fentanyl or nalbuphine for post-operative analgesia in lower limb surgeries

Comparison of Epidural Bupivacaine and Buprenorphine to Bupivacaine and Butorphanol for Postoperative Analgesia in Lower Limb Orthopedic Surgery

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