Indian Journal of Anaesthesia  
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Year : 2013  |  Volume : 57  |  Issue : 2  |  Page : 150-155

Effectiveness of butorphanol as an adjuvant to lidocaine for haematoma or periosteal block: A prospective, randomised, double blind study

1 Department of Anaesthesiology and Critical Care, Rajiv Gandhi Institute of Medical Sciences, Putlampalli, Kadapa, India
2 Department of Anaesthesia, Sri Venkata Ramana Ruiah Government General Hospital, Tirupathi, Andhra Pradesh, India

Correspondence Address:
Nawaz Ahmed Shaik
Department of Anaesthesiology and Critical Care, Rajiv Gandhi Institute of Medical Sciences, Putlampalli, Kadapa - 516 002, Andhra Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0019-5049.111841

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Background: The peripheral nerve endings carrying pain contains opiod receptors. Blocking these receptors during haematoma block or periosteal block may provide better analgesia. Aim: Evaluation of effectiveness and safety of butorphanol as an adjuvant to lidocaine for haematoma block. Settings and Design: This is a two centre, prospective, individually randomised, two group, parallel, double-blind clinical trial. Methods: In this study, 115 American society of anaesthesiologist grade I and II adult patients scheduled for closed reduction of fractures were randomly allocated into two groups; Group A received 1% lidocaine (2 mg/kg) where as Group B received 1% lidocaine (2 mg/kg) with butorphanol (0.02 mg/kg) during haematoma block. Pain was assessed before, during and after manipulation of fracture by using visual analogue scale (VAS 0-10). Onset time of block, time for first rescue analgesic, 24 hour analgesic requirement and sedation levels were noted. Statistical Analysis: Data analysed with the unpaired t-test with Welch correction assuming unequal variances and Fisher's exact test using Graph pad Prism 5.02 version. Results: Onset time of haematoma block was significantly less in the butorphanol group compared to the lidocaine group ( P=0.0003). The mean time for first rescue analgesic was significantly higher and total analgesic requirement was significantly lower in the butorphanol group ( P<0.0001). Mean VAS scores were lower and sedation scores were higher in the butorphanol group. Conclusions: Addition of butorphanol to lidocaine quickens onset of haematoma block, provides excellent post manipulation analgesia and decreases 24 hour total analgesic requirement without excessive sedation.

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