title: Epidural butorphanol-bupivacaine analgesia for postoperative pain relief after abdominal hysterectomy.
abstract: OBJECTIVE
  To determine the efficacy of epidural butorphanol with and without bupivacaine in providing postoperative analgesia following abdominal hysterectomy.
  
  
  METHODS
  Randomized, double-blinded study.
  
  
  METHODS
  Postoperative recovery area of a university-affiliated medical center.
  
  
  METHODS
  60 ASA physical status I and II women, aged 20-65 years, undergoing abdominal hysterectomy.
  
  
  METHODS
  Patients were randomly allocated to three groups during the postoperative period to receive one of three epidural regimens: two mg of butorphanol in 10 mL of normal saline (Group 1), two mg of butorphanol in 10 mL of 0.125% bupivacaine (Group 2), or two mg of butorphanol in 10 mL of 0.25% bupivacaine (Group 3).
  
  
  METHODS
  Onset and duration of analgesia were recorded. Hemodynamic variables, pain scores, sedation scores, and respiratory rate were monitored for 24 hours. Frequency and severity of respiratory depression, sedation, pruritus, nausea, and vomiting were recorded.
  
  
  RESULTS
  The addition of butorphanol to bupivacaine resulted in significantly (P < 0.05) faster onset of pain relief. The duration of analgesia was prolonged in patients receiving butorphanol with bupivacaine combination (8.68 +/- 0.82 hrs, 9.82 +/- 0.54 hrs) as compared with butorphanol alone (4.35 +/- 0.66 hrs; P < 0.05). The differences between Groups 2 and 3 were not significant.
  
  
  CONCLUSIONS
  Addition of two mg of butorphanol to 0.125% of epidural bupivacaine resulted in rapid onset and longer duration of analgesia than did butorphanol alone.
authors.affiliation: Department of Anesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India. bhartineerja@yahoo.com
authors.forename: Neerja
authors.initials: N
authors.lastname: Bharti
authors.forename: Pramila
authors.initials: P
authors.lastname: Chari
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D015360:Analgesia, Epidural / Q000379:methods; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D002045:Bupivacaine / Q000008:administration & dosage / Q000627:therapeutic use*; D002077:Butorphanol / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D002077:Butorphanol; D002045:Bupivacaine