Intrathecal Nalbuphine an Effective Adjuvant for Post Operative Analgesia (A Comparitive Study with Fentanil)
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 1
Abstract
Introduction: Various adjuvants have been used along with local anaesthetics for prolongation of analgesia post operatively in neuraxial blockade. The frequently used adjuvants are opioids, midazolam, neostigmine, ketamine etc. Neuraxial opioids bind to intrathecal opioid receptors and produce effective pain relief post operatively with minimal untoward effects. Nalbuphine is an opioid drug with mixed μ antagonist and κ agonist properties. Thus we conducted a prospective, randomized, comparative study to observe the effect of 0.5% hyperbaric Bupivacaine 3 ml on pain relief after lower limb and lower abdominal surgeries and compare it with effect of intrathecal Nalbuphine + 0.5% hyperbaric Bupivacaine 3 ml. Material and methods: 60 patients of ASA grades I and II of either sex in the age group of 20-60 years will be randomly allocated to one of the two groups. Group B (n = 30) received 3 ml of 0.5% hyperbaric bupivacaine intrathecally; group N (n = 30) received 3 ml of 0.5% hyperbaric bupivacaine + 1 mg nalbuphine intrathecally. The onset of sensory and motor blockade, duration of motor blockade and analgesia, VAS score, haemodynamic and side effects will be recorded, tabulated, and analysed. Result: The onset of complete motor block was more rapid with fentanyl than nalbuphine and this was statistically significant (p<0.05). The duration of post-operative analgesia and the effective analgesic time were more prolonged in nalbuphine group than in fentanyl group with no statistically significant difference. As regards the side effects, they were less in nalbuphine group than the fentanyl group Conclusion: In our study we conclude that both Nalbuphine or Fentanyl in combination with low dose hyperbaric bupivacaine (15mg) are equally efficacious and haemodynamically stable in patients undergoing lower limb surgeries. However, Nalbuphine with comparatively prolonged post operative analgesia and effective analgesia time and lesser side effects is a better adjuvant than Fentanyl for intrathecal injections of Bupivacaine 0.5%(H) in surgeries undergoing spinal anaesthesia. with no statistically significant difference.
Authors and Affiliations
Jaideep Singh, Aditya Agarwal, Ajay Vatal
Keywords
Related Articles
- EP ID EP424949
- DOI -
- Views 133
- Downloads 0
A Study on Functional Outcome of Conservative Management of Stage 2 and 3 Avascular Necrosis of Femoral Head
Introduction: The standard treatment for stage 2 and 3 AVN is surgery, core decompression and total hip replacement. Conservative management of stage 2 and 3 AVN with muscle strengthening exercises, intermittent skin tra...
Comparative Study to Know Efficacy of Topical Minoxidil (2%) Versus Topical Diltiazem (2%) in Chronic Anal Fissure Healing
Introduction: Chronic Anal fissure (CAF) is an elliptical ulcer in the anal canal extending from dentate line to the anal verge with sentinel pile or hypertrophied papilla. It is associated with hypertonia of the interna...
Comparison of Locoregional Control, Acute Radiation Toxicities and Patient Compliance between Two Different Radiation Fractionation Schedules with Concurrent Chemotherapy in Oropharyngeal Cancer
Introduction: Irrespectively of the modality of primary treatment for head and neck squamous cell carcinoma, local or locoregional residual or recurrent tumors represent the major cause of treatment failure, emphasizing...
Outcome of Patients with Subdural Hemmorage based on Glasgow Coma Score - Mild, Moderate and Severe Head Injured Patients
Introduction: Subdural haematoma is the most common focal intracranial lesion and occurred in 24% of patients in the TBI with severe closed head injury. Despite major advances in modern head injury management, patients i...
Sexual Assault: a Social Dilemma Prevalence and pattern of Cases Presented at a Teaching Hospital, Lahore
Introduction: Globally, sexual assault is a heinous crime and a serious social and health problem, mostly affecting women. The situation regarding this social ailment is also alarming in Pakistan. The aim of the study wa...