Comparative Study Of Butorphanol V/S Buprenorphine In Supraclavicular Brachial Plexus Block For Postoperative Analgesia

Abstract

INTRODUCTION: Supraclavicular Brachial plexus block provides anaesthesia for surgeries around elbow, forearm and hand. With advent of opioid receptors, variety of opioid agents are used for postoperative analgesia via brachial plexus block. Butorphanol and Buprenorphine can be used along with local anaesthetics to provide post op analgesia.

AIMS: 1) To study the onset and extent of blockade. 2) To study and compare perioperative complications. 3) To compare the duration of postoperative analgesia in two groups.

METHODOLOGY: A study was carried out in 30 patients aged 18-60yr of ASA grade I&II of either sex in each group undergoing orthopedic upper limb surgeries via supraclavicular brachial plexus block. Injection Butorphanol 1mg (Group-I)and Buprenorphine100µg (Group-II) were added to local anaesthetic mixture. Study was carried out at Shri B.M.Patil medical College& Hospital, Bijapur between the academic years 2007 to 2009 after taken informed consent under medical ethics. All patients were observed for onset of sensory and motor blockade, extent of blockade & Complications. PR, BP were monitored intraoperatively every 15 min of interval and postoperatively. All patients were observed for analgesia hourly until patient demanded analgesia post-operatively by VAS pain score. X SUMMARY OF RESULTS: Duration of sensory as well as motor and also complete blockade were comparable in both Groups which shows that Group II Buprenorphine had delayed onset compared to Group I Butorphanol. In Group I patients, VAS score was 39.44  16.66 at the end of 5 hours while in Group II patients 50.35  25.65 VAS score at the end of 8 hours. So the duration of analgesia was upto 5-6 hours in Group I, where it was upto 8-9 hours in Group II.

CONCLUSION: Both drugs are potent analgesic in brachial plexus block, but Buprenorphine is more potent and produces longer duration of postoperative analgesia than Butorphanol.