Comparative Study Of Tramadol And Butorphanol As Adjuvants To Levobupivacaine In 3 In 1 Block For Post Operative Analgesia In Fracture Femur Surgeries

Postoperativepain is often undertreated. Safe and effective pain management should be theprimary goal to improve patient rehabilitation and satisfaction. Post operativepain relief can be achieved by a variety of techniques including parentalNSAIDS (non-steroidal anti-inflammatory drugs), opioids, epidural analgesia,patient controlled analgesia and peripheral nerve blocks. Three in one femoralnerve block is relatively simple to perform, effective, low risk technique witha high success rate.

The 90 patients ASA grade I-II in age group 18-80years undergoing fracture femur surgery at SGRD Amritsar will be studied withthe aim of evaluating the effectiveness of addition of tramadol or butorphanolas adjuvants to levobupivacaine vs levobupivacaine and saline through 3 in 1femoral nerve block randomly divided into 3 groups with 30 patients eachreceiving preemptive three in one nerve block either using 0.25%Levobupivacaine alone (Group I) or tramadol 1mg/kg (Group II) or butorphanol 0.06mg/kg as adjuvant to 0.25% levobupivacaine (Group III). To every patientspinal anaesthesia using 0.5% heavy bupivacaine will be given. Ease ofpositioning, pain relief, and duration of post operative analgesia in all thethree groups will be compared. In addition, post operative requirement ofintravenous diclofenac 75 mg will be evaluated.