DOI: 10.36347/sjams.2018.v06i05.039

Pages: 2066-2072

Opioids have an important place as adjuvant to local anaesthetic agents in the management of spinal anaesthesia, the most commonly used being fentanyl. Other alternatives like opioid agonist antagonist agents like nalbuphine, butorphanol and buprenorphine are now being studied as adjuvants to prolong the duration of sensory and motor block with lower incidence of opioid related side effects. 60 patients belonging to ASA status I and II of either sex were randomly divided into three groups of 30 each to receive either butorphanol25 µg (Group A) or fentanyl 25 mcg (Group B) ) with 2.5 mL 0.5% hyperbaric bupivacaine, making intrathecal drug volume to 3mL in each group. . Sensory and motor block characteristics in terms of time to onset and duration were recorded for each group. Drug related side effects of pruritus, nausea/vomiting, and respiratory depression were also recorded. The two groups were comparable regarding the demographic profile. The fentanyl group showed delayed onset of sensory block (274 ± 73.39 sec) as well as a longer duration of sensory block (145.07 ± 5.34 mins vs 141.33 ± 3.51) than butorphanol. The duration of motor block was also prolonged in the fentanyl group(149 ± 7.13 vs 140.37 ± 2.31) . Both the findings were significant. Butorphanol provided a significantly longer duration of postoperative analgesia (250.10 ± 4.05 vs 244 ± 7.11 min) . No drug related side effects were observed in either group. Addition of 25 μg of butorphanol as adjuvant to hyperbaric bupivacaine 0.5% provides a faster onset of sensory block as compared to 25 μg fentanyl. Fentanyl provided a significantly greater duration of both sensory and motor block than butorphanol. The duration of postoperative analgesia was significantly greater with butorphanol.