Comparison of Butorphanol Tartrate and Tramadol Hydrochloride for Post-Operative Pain Relief Following Abdominal Surgery: A Prospective, Randomized, Double-Blind Study

Background: Butorphanol tartrate is a mixed synthetic agonist-antagonist opioids analgesic used for the management of post-operative pain in minor and major surgical procedures. Tramadol hydrochloride is a centrally acting mµ receptor agonist, frequently used as an analgesic. Aim: The purpose of this study was to compare the analgesic efficacy and side effects of equipotent moderate doses of butorphanol and tramadol. Materials and Methods: In the present randomized, prospective, double-blind study, 60 patients of either sex, aged between 18 and 60 years, American Society of Anesthesiologists physical status Grade I and II undergoing elective abdominal surgeries under general anesthesia were enrolled in the study. Patients were randomly assigned to two groups (30 patients each); Group B received injection butorphanol 2 mg and Group T received injection tramadol 100 mg, 10 min prior to extubation. Patient’s visual analog scale (VAS), duration of analgesia, the number of doses required in 24 h, and side effects were noted. Results: In the present study, the mean duration of analgesia after the first dose was 3.42 h in Group B and 6.46 h in Group T. The mean number of doses required in 24 h was 4.3 in Group B and 2.4 in Group T. At 0-¼ h, mean reduction in VAS was 3.0 in Group B and 1.57 in Group T. Mean reduction at 0-4 h was 0.33 in Group B and 4.56 in Group T. Thus, evident that analgesic effect of butorphanol wears off after 4 h while tramadol has peak effect at 3-4 h. Side effects such as vomiting were present in 30% patients in Group B as compared to 60% patients in Group T.