Journal of AdvancedMedical and Dental Sciences Research

Aim:To assess the effectiveness of analgesia and anesthesia using intrathecal administration of Butorphanol and Fentanyl in combination with Bupivacaine 0.5% Heavy for lower limb orthopedic surgery. Materials and methods: This prospective randomized double-blind study was conducted on 120 patients undergoing various lower limb orthopaedic surgeries under subarachnoid block at tertiary care center.After meeting inclusion criteria 120 patients were randomly divided into 2 groups, 60 each based on computer generated randomization table. Group A: Received 2.5ml of 0.5% hyperbaric bupivacaine with 0.5ml (25μg fentanyl) a total volume of 3ml intrathecally. Group B: Butorphanol was diluted using distilled sterile water to obtain 25μg in 0.5ml. This was then added to 2.5ml of 0.5% hyperbaric bupivacaine to make a total volume of 3ml. Results: The two groups were similar in terms of Age, Sex, Height, Weight, BMI, degree of SAB, ASA score, and kinds of surgery (P values >0.05). The durations for the initiation of sensory and motor blockage were similar across the two groups. The group that received intrathecal butorphanol saw a significantly slower decline to S2 level compared to the group that received intrathecal fentanyl (P<0.0001). Group A had a significantly greater number of patients who required rescue analgesia during the postoperative period compared to group B (P=0.03). In group A, the average time to first request for rescue analgesia was 256.74 ± 10.11 minutes, whereas in group B it was 291.70 ± 7.11 minutes (P<0.0001). Conclusion: Both 25μg fentanyl and 25μg butorphanol, when administered intrathecally with 12.5 mg of hyperbaric bupivacaine, effectively induce anesthesia for lower limb procedures. The combination of bupivacaine and butorphanol administered intrathecally offers a longer period of sensory blocking and better pain relief compared to the combination of fentanyl and bupivacaine administered intrathecally.