Volume : 6, Issue : 7, July - 2017

A Comparative study of intrathecal butorphanol and fentanyl as an adjuvant to bupivacaine(heavy) for lower limb orthopedic Surgeries.

Dr. Vikas Kumar Gupta, Dr. Abhay Raj Yadav, Dr. Aditya Agarwal

Abstract :

<p>&nbsp;INTRODUCTION &nbsp; Neuraxial block for lower limb surgeries are becoming popular as it has many advantages over general anaesthesia .Spinal anaesthesia consists of temporary interruption of nerve transmission in the subarachnoid space produced by the injection of a local anaesthetic solution in the subarachnoid space&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Neuraxial opioids are widely used in conjunction with local anesthetics (LA) as they permit the use of lower dose of LA while providing adequate anesthesia and analgesia. The objective of the study was to compare the efficacy of butorphanol and Fentanyl as an adjuvant to local anaesthetics in relation to onset, degree and recovery time of sensory and motor blockade and Hemodynamic changes in orthopaedic procedures done under spinal anaesthesia. &nbsp; Materials &amp; Methods &nbsp;&nbsp;The present study will be conducted in&nbsp; the Department of anaesthesiology, Gandhi Medical College and Hamidia Hospital, Bhopal on patients of diagnosis with lower limb orthopedic Surgeries&nbsp; scheduled for elective surgeries. A detailed&nbsp; physical examination was carried out a day before the proposed surgery, Written and informed consent before participation in study will be taken &nbsp; Inclusion Criteria:- &nbsp;After obtaining approval from institutional ethics committee and informed written consent from patients .80 consented adult patient of ASA Grade I &amp; II, Aged between 20-60 years, were included in the study. &nbsp; Exclusion criteria:- Patients refusal to participate in the study, contraindications for spinal anesthesia ,Sensitivity to study drugs, Recent onset of MI (&lt;3months) , hypovolemic patient ,patients with renal or hepatic impairment.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp; RESULT Both&nbsp; butorphanol and&nbsp; fentanyl given intrathecally with hyperbaric bupivacaine provide effective and safe anesthesia for lower limb surgeries with minor side effects. &nbsp; &nbsp;CONCLUSION Intrathecal bupivacaine-butorphanol provides longer duration of sensory blockade and better quality of analgesia than intrathecal fentanyl-bupivacaine.</p>