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Comparison of Butorphanol and Buprenorphine as an Adjunct to Local Anaesthetic Solution

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Introduction: Opioids are well studied adjuncts although the evidence regarding the analgesic benefit of opioid adjuncts remain equivocal. The effectiveness of buprenorphine and butorphanol administered as adjuncts to local anaesthetic solution into brachial plexus sheath was evaluated. Aim: The objectives of this study are to compare between Butorphanol and Buprenorphine as an adjunct to local anaesthetic solution in supraclavicular brachial plexus block with respect to – Duration of sensory and motor block, duration of analgesia and untoward side effects. Materials and Methods: The study was a randomized prospective double blind and comparative study carried in 60 ASA grade I and II patients undergoing elective upper limb surgeries, aged between 18­60 years were randomly allocated into 2 groups of 30 each. All patients received 1% lignocaine plain 2mg/kg and 0.5% bupivacaine at 2mg/kg body weight. In addition, 30 patients in group A received butorphanol tartarate (30mcg/kg) while the 30 patients of group B received buprenorphine hydrochloride (3mcg/kg). Using VAS score the analgesia was evaluated every hourly for six hours, every two hours for next twelve hours and then every six hours till 48 hours. Result: heart rate pattern of both groups shows statistical significance at 10th to 13th hour of the study period. systolic blood pressure changes between two groups shows statistical significance between 9th to 11th and 14th, 15th, 16th, 18th, 20th and 24 hrs. diastolic blood pressure between two groups show statistical significance between 8th­12th hr and 18th, 20th and 24th hr. Statistical significance with respect to respiratory rate at 2nd to 5th hr, 14th hr, 16th hr to 20th hr, 28th hr and 48th hr.postoperative pain using visual analogue scale (VAS) between the two groups with statistical significance at 3rd, 9th, 11th­13th, 17th and 18th hrno statistical significance in terms of onset, duration of surgery, sensory and motor blockade between the two groups. Average duration of analgesia were 14.13±8.41hr and 22.18±12.13hr in groups A and B respectively, showed statistical significance. The group B showed prolonged analgesia produced by addition of buprenorphine to local anaesthetic. Side effects like nausea, vomiting and numbness were comparable in both groups without any significance. Conclusion: We conclude that buprenorphine as an adjunct administered with local anaesthetics into brachial plexus sheath is an efficient way to overcome the perioperative pain in upper limb surgery.

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Introduction: Opioids are well studied adjuncts although the evidence regarding the analgesic benefit of opioid adjuncts remain equivocal. The effectiveness of buprenorphine and butorphanol administered as adjuncts to local anaesthetic solution into brachial plexus sheath was evaluated. Aim: The objectives of this study are to compare between Butorphanol and Buprenorphine as an adjunct to local anaesthetic solution in supraclavicular brachial plexus block with respect to – Duration of sensory and motor block, duration of analgesia and untoward side effects. Materials and Methods: The study was a randomized prospective double blind and comparative study carried in 60 ASA grade I and II patients undergoing elective upper limb surgeries, aged between 18­60 years were randomly allocated into 2 groups of 30 each. All patients received 1% lignocaine plain 2mg/kg and 0.5% bupivacaine at 2mg/kg body weight. In addition, 30 patients in group A received butorphanol tartarate (30mcg/kg) while the 30 patients of group B received buprenorphine hydrochloride (3mcg/kg). Using VAS score the analgesia was evaluated every hourly for six hours, every two hours for next twelve hours and then every six hours till 48 hours. Result: heart rate pattern of both groups shows statistical significance at 10th to 13th hour of the study period. systolic blood pressure changes between two groups shows statistical significance between 9th to 11th and 14th, 15th, 16th, 18th, 20th and 24 hrs. diastolic blood pressure between two groups show statistical significance between 8th­12th hr and 18th, 20th and 24th hr. Statistical significance with respect to respiratory rate at 2nd to 5th hr, 14th hr, 16th hr to 20th hr, 28th hr and 48th hr.postoperative pain using visual analogue scale (VAS) between the two groups with statistical significance at 3rd, 9th, 11th­13th, 17th and 18th hrno statistical significance in terms of onset, duration of surgery, sensory and motor blockade between the two groups. Average duration of analgesia were 14.13±8.41hr and 22.18±12.13hr in groups A and B respectively, showed statistical significance. The group B showed prolonged analgesia produced by addition of buprenorphine to local anaesthetic. Side effects like nausea, vomiting and numbness were comparable in both groups without any significance. Conclusion: We conclude that buprenorphine as an adjunct administered with local anaesthetics into brachial plexus sheath is an efficient way to overcome the perioperative pain in upper limb surgery.

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This page is a summary of: Comparison of Butorphanol and Buprenorphine as an Adjunct to Local Anaesthetic Solution in Supraclavicular Brachial Plexus Block, Indian Journal of Anaesthesia and Analgesia, January 2018, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.51018.3.
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