Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
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A Clinical Comparative Study of Butorphanol Versus Buprenorphine as an Adjunct to Local Anaesthetic Solution of Bupivacaine in Supra Clavicular Brachial Plexux Block
Pallavi Ghose, Suneeta Dutta and Kalyan Sarma
Page: 480-485 | Received 20 Aug 2024, Published online: 06 Jan 2025
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Abstract
Postoperative pain relief is mainly based on opioids. However the use of conventional administration of opioid through intramuscular, intravenous routes is associated with a variety of perioperative side effects like ventilatory depression, sedation, postoperative nausea and vomiting (PONV), pruritus, urinary incontinence, ileus, constipation Peripheral blockade remains a well accepted component of comprehensive anaesthetic care. The existence of opioid receptors in peripheral nerve tissue has led incorporating small doses of opioids in peripheral nerve blocks. The objective of this study is to compare between Butorphanol with local anaesthetics and Buprenorphine with local anaesthetics in supra clavicular brachial plexus block with respect to. Duration of sensory and motor blockade. Duration of analgesia. Untoward side effects. Secondary objective was to study any difference in the onset of sensory and motor blockade between the Butorphanol and Buprenorphine groups. This single‐centre, double‐blind, randomized controlled trial involved 100 patients scheduled for elective upper limb orthopaedic surgery. A comparative study consisting of 50 patients in Group A ( Butorphanol) and 50 patients in Group B (Buprenorphine) was undertaken to study the change pattern of hemodynamic, pain score by NRS, duration of analgesia, duration of sensory, duration of motor blockade and side effects. All patients received supra clavicular brachial plexus block with 0.25% Bupivacaine. Pain was assessed using a numerical rating scale in the post‐anaesthesia care unit. Chi‐square test and Mann‐Whitney U test was used for analysis. A P value <0.05 was considered to be statistically significant. There was no significant difference in the mean time of onset of sensory block between Group A and Group B (p=0.1998). There was no significant difference in the mean time of onset of motor block between Group A and Group B (p=0.1687). There was no significant difference in the mean duration of sensory block between Group A and Group B (p=0.7759). There was no significant difference in the mean duration of motor block between Group A and Group B (p=0.9505). However there was significant difference in the mean duration of analgesia between Group A and Group B (p<0.0001). The difference in the total number of analgesic doses consumed by Group A and Group B was also statistically significant with Group A consuming more number of analgesic doses. From this study it was observed that both buprenorphine and butorphanol prolonged the duration of analgesia. Buprenorphine (3 mcg/kg body weight) prolonged the duration of analgesia and decreased the need of rescue analgesic doses more than butorphanol (0.03 mg/kg body weight), when added as an adjunct to local anaesthetic solution into the brachial plexus sheath for peri‐operative analgesia during upper limb surgery without any significant changes in the block characteristics or any complications observed in either group.
How to cite this article:
Pallavi Ghose, Suneeta Dutta and Kalyan Sarma. A Clinical Comparative Study of Butorphanol Versus Buprenorphine as an Adjunct to Local Anaesthetic Solution of Bupivacaine in Supra Clavicular Brachial Plexux Block.
DOI: https://doi.org/10.36478/10.36478/makrjms.2025.1.480.485
URL: https://www.makhillpublications.co/view-article/1815-9346/10.36478/makrjms.2025.1.480.485