INTRATHECAL NALBUPHINE IN DIFFERENT DOSES AS AN ADJUVANT TO SUBARACHNOID BLOCK
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 37
Abstract
BACKGROUND We searched for an ideal agent which can be universally used in all situations, easily available and cost effective with less side effects, so we studied the effect of nalbuphine a synthetic opioid analgesic that has both agonist and antagonist narcotic properties, added in different doses as an adjunct to bupivacaine and compared it with bupivacaine alone. MATERIALS AND METHODS Patients were randomly allocated into four groups. Each group consisted of 30 patients. They received either Bupivacaine 0.5% heavy (Group 1) or Groups (2, 3 and 4) received Bupivacaine 0.5% heavy with nalbuphine in dose range of .5 mg, .75 mg and 1 mg respectively. They were given the said drugs intrathecally in L3-L4 interspace with 25 G needle. Onset of motor and sensory loss was noted before positioning the patient. Intraoperative monitoring of fluid management was done depending on the blood loss and haemodynamic parameters. Two segment regression time of sensory blockade was assessed, and pain was assessed by VAS at the time of 1st pain medication. RESULTS The mean onset time of sensory block of Group 3 and 4 was significantly early as compared to the onset of sensory block as compared to Group 1 and 2. The quality of analgesia provided with addition of nalbuphine in Group 2, 3 and 4 is significantly good as compared to bupivacaine group alone. Two segment regression of sensory blockade, duration and the quality of analgesia was significantly prolonged by addition of intrathecal nalbuphine and was significantly more in Group 4 as compared to other groups. CONCLUSION From our study, we conclude that for spinal anaesthesia 1 mg of nalbuphine when added to 0.5% hyperbaric bupivacaine provides excellent analgesia with longer duration of action and minimal side effects.
Authors and Affiliations
Ashoka Kumar Panigrahi, Bimal Krushna Panda, Alok Kumar Panigrahy, Kulwant Lakra, Sanjeeb Kumar Mishra
Keywords
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- EP ID EP548000
- DOI 10.14260/jemds/2018/913
- Views 100
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