Abstract

Background and Objectives Aim of this study was to compare the efficacy in providing post operative analgesia in abdominal hysterectomy by epidurally administered combination of ropivacaine with tramadol vs. ropivacaine with butorphanol. The study was done to compare the onset time of analgesia, the duration of analgesia, and the side effects of the combination of drugs (ropivacaine-tramadol & ropivacaine-butorphanol ) when administered epidurally

Methods: This study was done among two groups of patients belonging to ASA1 &11,who underwent abdominal hysterectomy. They are comparable with regards to age, height and weight. Patients were allocated in to two study groups, named A and B using computer generated randomization. Group A received 8 ml of Ropivacaine (0.20%) with 50 mg (1 ml) Tramadol and Group B received 8 ml of Ropivacaine (0.20%) with 1 mg (1 ml) Butorphanol epidurally. (The groups were later redesignated as group RT (group A) and group RB (group B) ).

Results: The mean time of onset of analgesia in group RT is 9 ±1.6 min, and in group RB it is 6.1±1.7 min. There is statistically significant difference (p<0.001) between the time of onset of analgesia between the two groups. The duration of analgesia is 4.3±0.1hours in group RT and 5.1±0.4 hours in group RB. Side effects like nausea, vomiting, hypotension and head ache are more in RT group. Sedation was more in group RB. No significant difference in motor blockade was observed in either group No serious side effects were observed in both the groups

Conclusion: Epidural bolus injection of both 0.2 % ropivacaine with 50 mg tramadol and 0.2 % ropivacaine with 1 mg butorphanol are effective for relieving post operative pain after abdominal hysterectomy. However   faster onset of analgesia,  longer duration  of analgesia and less adverse reactions  are observed when butorphanol is used as an adjuvant with 0.2%ropivacaine.

Keywords: epidural, ropivacaine, tramadol, butorphanol.