Title: Comparison of Post Cesarean Analgesia with Epidural Bupivacaine-Fentanyl v/s Bupivacaine-Nalbuphine v/s Bupivacaine-Butorphanol – A Double Blinded Randomized Study
Authors; A Karthik, Satish Logidasan, Arulraj G.P, R Kanimozhi, A Gowri Shankar, S Prasana Vathanan, Ambal S, C Sathish, S.R. Karthick
DOI: https://dx.doi.org/10.18535/jmscr/v7i2.176
Abstract
80 ASA physical status I and II women, aged 20-30 years, undergoing Elective Cesarean Section were included in the study. Patients were randomly allocated to four groups during the postoperative period to receive one of four epidural regimens: Group 1(NS): 10ml of 0.125% Bupivacaine + 1ml of Normal Saline; Group 2(FENT) 10ml of 0.125% Bupivacaine + 50ug of Fentanyl (1ml); Group 3(NALB) 10ml of 0.125% Bupivacaine + 5mg of Nalbuphine (0.5ml) +0.5ml of Normal saline to make it into 1ml; Group 4 (BUTOR): 10ml of 0.125% Bupivacaine + 1mg of Butorphanol (1ml).
Onset and duration of analgesia were recorded. Hemodynamic variables, pain scores, sedation scores, and respiratory rate were monitored for 24 hours. Frequency and severity of respiratory depression, sedation, pruritus, nausea, and vomiting were recorded. The mean onset of analgesia and times to reach peak analgesia were significantly shorter while the mean durations of analgesia were significantly longer in the groups receiving fentanyl, nalbuphine & butorphanol than in the group receiving bupivacaine alone. The onset of analgesia was earliest with Butorphanol group. The duration of analgesia was maximum with Butorphanol group. None of the patients developed hypotension, Bradycardia, respiratory depression.
Epidural 0.125% Bupivacaine combined with Butorphanol produces significantly earlier onset, longer duration and better quality of analgesia than 0.125% Bupivacaine - Nalbuphine combination / 0.125% Bupivacaine -Fentanyl combination / 0.125% Bupivacaine alone and is safe in parturients.
