Nalbuphine as an Adjuvant to Bupivacaine 0.5% Heavy for Lower Limb and Lower Abdominal Surgeries

What is it about?

Nalbuphine as an Adjuvant to Bupivacaine 0.5% Heavy for Lower Limb and Lower Abdominal Surgeries

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Photo by Danielle Cerullo on Unsplash

Photo by Danielle Cerullo on Unsplash

Why is it important?

Introduction: Opioids have been extensively used as an adjuvant because of excellent results in neuraxial blocks. Fentanyl is widely used but is found to have higher incidence of pruritus for which Nalbuphine was considered as an adjuvant. Aim: To compare the efficacy of Fentanyl and Nalbuphine as an adjuvant to bupivacaine 0.5% heavy. Methods and Material: Randomised control trial was carried out on 60 patients between 1860 years of age and ASA grade I and II with groups having 30 patients each: GROUP A Bupivacaine (2.5 ml) + Fentanyl 25µg (0.5 ml), GROUP B Bupivacaine (2.5 ml) + Nalbuphine 400ug (0.5 ml). The observation and results were compared and statistical analysis was done. Statistical analysis was performed by the SPSS program for Windows. For comparing the two main groups Paired t test was applied. In this study p value < 0.05 is considered as statistically significant. Results: Onset of sensory block was significantly rapid with nalbuphine (2.05±0.887 mins) as compared to fentanyl group (4.67±0.816mins) (p<0.001). The duration of analgesia was statistically prolonged with fentanyl (244.27±5.457mins), compared with the nalbuphine (243.25±8.091 mins). (p< 0.05) but it was clinically not significant. Conclusion: 400 mcg intrathecal nalbuphine is superior to 25mcg intrathecal fentanyl regarding the duration of analgesia and reduced the analgesic requirement in the early postoperative period.

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