European Journal of Molecular & Clinical Medicine

Background: Pain has already been accepted as the sixth vital sign. Hence, attenuation of pain and alleviation of human suffering is of paramount importance in respect to the service provided by anaesthesiologists, for whom the patients submit a virtual suicidal note in the form of expressed consent. Hence, the importance of the study is self-explanatory.
Objective: The purpose of this study was to clinically evaluate the efficacy of post-operative analgesia with epidural Bupivacaine with Butorphanol, Bupivacaine with Fentanyl and Bupivacaine with Nalbuphine.
Material & Method: 75 patients belonging to ASA Ι and ΙΙ, undergoing lower abdominal surgeries were divided into three groups.
Group A: 0.125% bupivacaine + 2 mg butorphanol.
Group B: 0.125% bupivacaine + 100 mcg. Fentanyl.
Group C: 0.125% bupivacaine + 10 mg Nalbuphine Under all aseptic conditions patients were given epidural block with loss of resistance technique.
Results & Conclusion: Conclusions are drawn from the Study: Opioid analgesics with local anesthetics are extremely safe, effective and reliable method of postoperative pain relief. Fentanyl produces faster onset of analgesia with fewer adverse effects like sedation, pruritus, and nausea and vomiting than butorphanol and nalbuphine when given epidurally along with 0.125% bupivacaine. Butorphanol administered epidurally has advantage of longer duration of analgesia than fentanyl or epidural nalbuphine with side effects like nausea vomiting and sedation.

Background: Total intravenous anaesthesia is technique which uses various drugs in combination, given exclusively by IV route to provide general anaesthesia to the patient. TIVA provides a good surgical plane, rapid induction, smooth the emergence from anaesthesia and rapid recovery. Thus making it a desirable alternative for day care surgeries. Propofol is IV anaesthetic agent, having a pharmacological profile favorable for TIVA. However it is known to cause respiratory depression and dose-dependent hypotension, and due its lack of analgesic properties there is a limitation on its employment. Ketamine known for its hypnotic, analgesic and amnesic properties. Butorphanol seems to provide good analgesia but is associated with adverse effects like cardio depressant action, dizziness and sedation.
Methods: A total of 60 patients who will be undergoing surgeries under TIVA in the age group of 20-60yrs will be taken up for this study. They would be further divided in two groups, Group PK will receive ketamine 1mg/kg 1 min prior to administration of propofol and propofol and group PB will receiving butorphanol 20μg/kg 1min prior to administration of propofol. Propofol will be given at a dose of 1.5ml/kg to both the groups during induction . In both the groups anaesthesia will be maintained with propofol 9mg/kg/hr . Patient will be monitored for various parameters such as non-invasive heamodynamic, respiratory parameters. Incidence of pain on injection Propofol, post-operative sedation, nausea, vomiting will also be looked for.
Results and Conclusion : Expected outcome of this study is that the combination of Propofol-ketamine, offers a better haemodynamic and respiratory stability over propofol- butorphanol combination. Pain on injection will be better attenuated by butorphaol than ketamine.