Comparison of Efficacy of Infusions Of Dexmedetomidine Versus Butorphanol as Sedative & Analgesic in Short General Anaesthesia In Day Care Gynaecological Surgeries

Abstract

Background And Goals: Development of selective alpha 2 adrenoceptor agonists may provide a new concept for the administration of periopertive anaesthesia & analgesia in day care surgeries. Goal of this study was to compare Inj. Dexmedetomidine & Inj.Butorphanol with respect to time required for onset & offset of sedation, quality of intraoperative as well as postoperative analgesia & the time required for post-operative recovery. Methods: After obtaining permission from Institutional Ethical Committee (IEC), study was conducted in 40 patients of ASA I and II divided into 2 groups A & B by computer generated random number table. Patients, in group A received inj Dexmedetomidine 1 mcg/kg i.v and group B received inj. Butorphanol 10 mcg/kg i.v, in infusion over 10 minutes prior to induction. Induction was done with inj Propofol i.v 2mg/kg & maintained with 33% O2, 66%N2O & 0.6-0.8% of isoflurane with patient breathing spontaneously. Throughout the surgery the sedation and analgesia was maintained with inj Dexmedetomidine 0.7 microgram/kg/hr infusion in group A and with inj Butorphanol 2 microgram/kg/hr in group B. Patients were evaluated in postoperative recovery room with help of Visual Analogue Scale (VAS) for pain, Ramsay Sedation Score & Standard Aldrete Score for recovery. Results: Demographically, the two groups were similar. Requirement of inhalational anaesthetic agents was significantly reduced in the group A (p < 0.05).VAS was significantly less(2.75 ± 0.44) in the group B after 90 min and earlier rescue analgesia was given in group A ( p < 0.05). Eye opening was earlier (45.5 ± 23.61) in group A and was highly significant (p < 0.001). Postop recovery was significantly improved (9.8 ± 0.41) with dexmeditomidine group. Conclusion: Dexmedetomidine produces better sedation and analgesia without significant adverse effects and can be used as sole sedative and analgesic for day care surgery patients with better recovery.