Epidural Butorphanol-Bupivacaine for Analgesia During Labor and Delivery

Hunt, Catherine; Naulty, J. S.; Malinow, Andrew M.; Datta, Sanjay; Ostheimer, Gerard W.

doi:10.1097/00132582-198910000-00057

Cited by 16 publications

(32 citation statements)

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“…No other side effects were seen in either group. Foetal effects like low amplitude sinusoidal pattern on foetal heart tracing have been described with 3 mg butorphanol [3]. No such patterns were seen in our study in either group.…”

Section: Discussioncontrasting

confidence: 63%

“…Hunt's study found the time of onset in the 1 mg butorphanol group to be 16.9 ± 3.6 minutes in the 2mg [3]. Our study showed that the time of onset in the 1.5 mg butorphanol group was 9.75 ± 5.55 minutes, but 15 ml of 0.1% bupivacaine was used in our study as compared to 10 ml of 0.25% bupivacaine in the Hunt study.…”

Section: Discussioncontrasting

confidence: 51%

“…The combination of epidurally administered opioids and local anaesthetics produce a more rapid onset and longer duration of analgesia [3]. Time-tested μ receptor agonists like fentanyl have been used in epidural labour analgesia alone and in combination with local anaesthetics [4][5][6][7].…”

Section: Discussionmentioning

confidence: 99%

“…Butorphanol has been successfully used in combination with bupivacaine in labour analgesia and has been found to produce effective labour analgesia. Hunt's study of a combination of 0.25% bupivacaine with 0,1,2, or 3mg of butorphanol in 40 patients with 10 patients in each group recommended 2 mg of butorphanol as the optimal dose for labour analgesia [3].…”

Section: Discussionmentioning

confidence: 99%

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Butorphanol-bupivacaine versus Fentanyl-bupivacaine for Extradural Analgesia during Labour

K¹,

Puri²,

Goel

2006

Medical Journal Armed Forces India

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Original Article IntroductionT he control of pain should forms an integral part of the management of labour, yet pain relief in labour is a controversial subject. Pregnant woman have a right to basic information about pain and its relief in labour. Labour analgesia, is rapidly catching up in the Armed Forces, and it would still be a while, before all women in labour are offered this service. Amongst the various modalities of pain relief in labour, epidurals have gained popularity. The aim of this study was to compare a relatively less utilised opioid, butorphanol with the timetested fentanyl in epidural labour analgesia. MethodThe study was approved by our hospital ethics committee and informed consent was obtained from each patient. 64 women with American Society of Anaesthesiologists physical status I and II, between the ages of 18 and 40 years who opted for epidural labour analgesia were enrolled. Participants had singleton pregnancy of greater than 36 weeks of gestation with vertex presentation. All women were in active labour with cervical dilatation of 3 to 5 cm at the time of epidural catheter placement. The women had a pre dose Visual Analog Score (VAS) for labour pain of ≥ 30mm measured on two occasions, when two consecutive uterine contractions occurred.Patients with known hypersensitivity to local anaesthetics, neurologic, neuromuscular or psychiatric disorders, blood dyscrasias, weight greater than 110 kg, height less than 144 cm, cephalopelvic disproportion, known foetal abnormalities or multiple pregnancy were excluded from the study.Randomisation was done by the toss of a coin and patients were allocated to two groups. The first group (n=32) received 15ml of 0.1% bupivacaine with 0.1mgml -1 butorphanol (1.5mg) and the second group (n=32) received 15ml of 0.1% bupivacaine with 2μgml -1 of fentanyl. The patient and anaesthesiologist were blind to the drug combination, which was prepared by a trained assistant.All patients were started on an intravenous infusion of ringer lactate. An 18 gauge epidural catheter was placed 3 to 4 cm inside the epidural space via an 18-gauge Tuohy epidural needle at the L2-3 or L3-4 level. If there was any evidence of entry into an epidural vein or cerebrospinal fluid the patient was excluded from the study. After negative aspiration, a bolus of 15 ml of either drug was given over 5 minutes. A test dose was omitted.The efficacy of the drug was assessed using a 100 mm visual analogue scale, where 0 represented no labour pain and 100 represented the worst possible pain, at five minute intervals and during contractions for the first 20 min, at 20 minute intervals for the first hour, at 30 minute intervals for the next hour, and hourly thereafter, till the end of labour or when patient complained of pain. -1 of fentanyl. Results: The times of onset and offset of analgesia were comparable. More patients of the butorphanol group were sedated but arousable. The patient satisfaction levels were good in both groups and APGAR scores were comparable. Conclusion: Butorphanol and fe...

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Section: Discussioncontrasting

confidence: 63%

Section: Discussioncontrasting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Butorphanol-bupivacaine versus Fentanyl-bupivacaine for Extradural Analgesia during Labour

K¹,

Puri²,

Goel

2006

Medical Journal Armed Forces India

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“…The finding was similar with the studies done by Abboud et al 10 and Palacios et al 15 . All the patients maintained a respiratory rate greater than 12 throughout the study period in the similar study done by Hunt et al 20 .…”

Section: Discussionmentioning

confidence: 62%

Epidural butorphanol for post operative analgesia in lower limb surgeries: A comparative study with epidural tramadol

Deo

Shrestha

2017

J Chitwan Med Coll

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To compare the efficacy of epidural butorphanol and tramadol for post operative analgesia in lower limb surgeries. Randomized, controlled, double blind, prospective study conducted at Department of Anaesthesia and Critical Care, Chitwan Medical College from September 1st 2015 to August 31st 2016. 60 patients of ASA Grade I and II of either sex, aged between 18-65 years willing for epidural analgesia for post operative analgesia were included in the study. They were divided into two groups: Group B- Butorphanol group and Group T- Tramadol group. Subjects of Group B received 2mg of Butorphanol and 0.25% Bupivacaine making a total volume of 10 ml and that of Group T received 100mg of Tramadol and 0.25% Bupivacaine also making a total volume of 10 ml. Analgesic efficacy was assessed by Visual Analogue Scale (VAS). The onset and duration of analgesia along with side effects were also assessed. The quality of analgesia was studied using time to independent mobilization and overall patient satisfaction. Total number of patients was 60, of ASA Grade I and II, aged between 18-65 years. The mean age of patients in Group B was 42.6±11.7 years and 46.1±11.2 years in Group T. Time of onset of analgesia after epidural injection was 7.4±0.9 minutes in Group B and 12.7±1.5 minutes in Group T and the difference was found to be statistically significant. Duration of analgesia was 317.1±99.1 minutes and 438.8±136.6 minutes in Butorphanol and Tramadol groups respectively which was also statistically significant. Sedation was significantly higher in butorphanol group whereas nausea and vomiting was higher in tramadol group. Quality of analgesia in terms of patient satisfaction was better with epidural butorphanol. Both epidural tramadol and butorphanol were effective in relieving post operative pain however butorphanol had lesser side effects and greater patient satisfaction compared to tramadol but the duration of action was relatively short.

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Recent advances in epidural and spinal analgesia and anaesthesia in obstetric patients

Kumar¹,

Aken²,

Vertommen³

1993

Baillière's Clinical Anaesthesiology

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Epidural Butorphanol-Bupivacaine for Analgesia During Labor and Delivery

Cited by 16 publications

References 0 publications

Butorphanol-bupivacaine versus Fentanyl-bupivacaine for Extradural Analgesia during Labour

Butorphanol-bupivacaine versus Fentanyl-bupivacaine for Extradural Analgesia during Labour

Epidural butorphanol for post operative analgesia in lower limb surgeries: A comparative study with epidural tramadol

Recent advances in epidural and spinal analgesia and anaesthesia in obstetric patients

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