title: Bier's block using lignocaine and butorphanol.
abstract: BACKGROUND
  Opioids are most commonly used as adjuncts in intravenous regional anesthesia (IVRA) to improve the quality of intraoperative and postoperative analgesia. There is paucity of literature on the use of butorphanol in IVRA.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the likely benefits of addition of butorphanol to lignocaine in Bier's block in terms of onset and duration of sensory block and also for analgesic requirement in postoperative period.
  
  
  METHODS
  A randomized double blind study was conducted at Tertiary Care Educational Institute.
  
  
  METHODS
  A total of 40 adult ASA I or II patients scheduled to undergo upper limb surgery were randomized in two groups (n=20). Group I received 3 mg/kg of lignocaine alone and group II received 1 mg butorphanol in addition to 3 mg/kg lignocaine. Sensory block onset time and time to recovery from sensory block after tourniquet deflation were noted using the pin prick method. Duration of postoperative analgesia was noted using a visual analogue scale. All the patients were compared for the time to first rescue analgesic consumption and total analgesic consumption in first 24 hours postoperatively.
  
  
  METHODS
  The statistical analysis was done using unpaired Student's t-test.
  
  
  RESULTS
  Our study showed significant prolongation of postoperative analgesia in group II as noted by the time to first analgesic requirement. Total analgesic consumption in first 24 hours postoperatively was less in group II. Sensory block onset time and time to recovery from sensory block after tourniquet deflation, did not show any significant difference between the two groups.
  
  
  CONCLUSIONS
  Addition of butorphanol to lignocaine in IVRA significantly prolongs the duration of postoperative analgesia and 24 hours analgesic consumption is less in patients receiving butorphanol along with lignocaine in IVRA. However, there is no effect on sensory block onset time and time to recovery from sensory block.
authors.affiliation: Department of Anaesthesia, Dayanand Medical College and Hospital, Ludhiana, India.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Bansal
authors.forename: Shikha
authors.initials: S
authors.lastname: Gupta
authors.forename: Dinesh
authors.initials: D
authors.lastname: Sood
authors.forename: Suneet
authors.initials: S
authors.lastname: Kathuria
authors.forename: Anurag
authors.initials: A
authors.lastname: Tewari
references.citation: Can Anaesth Soc J. 1977 Jan;24(1):90-102
references.pmid: 318908
references.citation: Can J Anaesth. 1997 Nov;44(11):1152-6
references.pmid: 9398953
references.citation: Lancet. 1963 Feb 2;1(7275):245-7
references.pmid: 13961403
references.citation: Anaesthesia. 1991 Apr;46(4):278-80
references.pmid: 2024745
references.citation: JAMA. 1965 Dec 20;194(12):1273-6
references.pmid: 5898079
references.citation: Reg Anesth. 1991 Jul-Aug;16(4):204-8
references.pmid: 1911495
references.citation: Anesth Analg. 2005 Apr;100(4):1189-1192
references.pmid: 15781543
references.citation: Anesth Analg. 1999 Apr;88(4):831-5
references.pmid: 10195533
references.citation: Anesth Analg. 1995 Jul;81(1):110-3
references.pmid: 7598236
references.citation: Anesth Analg. 1999 Dec;89(6):1482-6
references.pmid: 10589633
references.citation: Anesth Analg. 1992 Oct;75(4):597-601
references.pmid: 1530172
references.citation: Pain. 1997 Sep;72(3):309-18
references.pmid: 9313271
references.citation: Anesth Analg. 2002 Aug;95(2):457-60, table of contents
references.pmid: 12145071
references.citation: Pain. 1997 Jun;71(2):119-21
references.pmid: 9211471
references.citation: Anesth Analg. 1982 Oct;61(10):834-8
references.pmid: 7125248
references.citation: Anesthesiology. 1984 Nov;61(5):507-10
references.pmid: 6093634
references.citation: Acta Neurol Scand. 1992 May;85(5):337-9
references.pmid: 1621496
references.citation: Saudi Med J. 2008 Aug;29(8):1151-5
references.pmid: 18690309
references.citation: Anaesthesia. 1979 Mar;34(3):231-5
references.pmid: 378016