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Nalbuphine as an Adjuvant to Ropivacaine in Patients undergoing Transurethral Resection of Prostate

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Spinal anaesthesia is commonly used in elderly patients who undergo transurethral resection of prostate (TURP) especially in those with compromised cardiorespiratory functions. Aims: To evaluate the efficacy of Nalbuphine when used as an adjuvant to Ropivacaine in spinal anaesthesia for Transurethral resection of prostate in terms of providing adequate sensory and motor blockade along with post operativeanalgesia and to look for any adverse effects. Methods: Fifty patients of the American Society of Anaesthesiologists (ASA) physical status II and III within the age group of 60 to 80 years were chosen for a prospective randomized double blinded comparative clinical study. Patients were divided into two groups. Group R received 2.5 ml of 0.75% Ropivacaine and 1 ml of normal saline. Group RN received 2.5 ml of 0.75% Ropivacaine and 1 mg of Nalbuphine (in 1 ml of normal saline). Sensory and motor blockade characteristics,post operative analgesia and adverse effects if any were studied. Statistical analysis: The data which was collected was tabulated using Microsoft Excel and analysis was done using SPSS version 16.0.Student t test was used to analyze the demographic and hemodynamic variables. Unpaired t test and chi square test were used to analyze the parameters which included onset, time, duration of sensory and motor blockade and also duration of analgesia. p value <0.05 was takenas statistically significant and p value <0.01 was considered as highly significant. Results: Patients in group RN had an early onset of sensory block at T10 (4.46±0.23min v/s 5.39±0.24 min). The duration of sensory (242.31±10.36 min v/s 175.70±9.78 min) and motor blockade(150.72±5.79 v/s 126.98±3.49) along with two segment regression times were prolonged in group RN when compared to group R. Post operative analgesia was also superior in group RN as total analgesic consumption was less in group RN (230.46±10.8 v/s 320.6±13.2). Conclusion: Addition of 1 mg of Nalbuphine to 0.75% Ropivacaine provided faster onset of sensory and motor blockade. Sensory and motor blockade was also prolonged. The post operative analgesia was enhanced in group RN with low visual analogue scale score (VAS score). Haemodynamic stability was well maintained without any incidence of adverse effects.

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Spinal anaesthesia is commonly used in elderly patients who undergo transurethral resection of prostate (TURP) especially in those with compromised cardiorespiratory functions. Aims: To evaluate the efficacy of Nalbuphine when used as an adjuvant to Ropivacaine in spinal anaesthesia for Transurethral resection of prostate in terms of providing adequate sensory and motor blockade along with post operativeanalgesia and to look for any adverse effects. Methods: Fifty patients of the American Society of Anaesthesiologists (ASA) physical status II and III within the age group of 60 to 80 years were chosen for a prospective randomized double blinded comparative clinical study. Patients were divided into two groups. Group R received 2.5 ml of 0.75% Ropivacaine and 1 ml of normal saline. Group RN received 2.5 ml of 0.75% Ropivacaine and 1 mg of Nalbuphine (in 1 ml of normal saline). Sensory and motor blockade characteristics,post operative analgesia and adverse effects if any were studied. Statistical analysis: The data which was collected was tabulated using Microsoft Excel and analysis was done using SPSS version 16.0.Student t test was used to analyze the demographic and hemodynamic variables. Unpaired t test and chi square test were used to analyze the parameters which included onset, time, duration of sensory and motor blockade and also duration of analgesia. p value <0.05 was takenas statistically significant and p value <0.01 was considered as highly significant. Results: Patients in group RN had an early onset of sensory block at T10 (4.46±0.23min v/s 5.39±0.24 min). The duration of sensory (242.31±10.36 min v/s 175.70±9.78 min) and motor blockade(150.72±5.79 v/s 126.98±3.49) along with two segment regression times were prolonged in group RN when compared to group R. Post operative analgesia was also superior in group RN as total analgesic consumption was less in group RN (230.46±10.8 v/s 320.6±13.2). Conclusion: Addition of 1 mg of Nalbuphine to 0.75% Ropivacaine provided faster onset of sensory and motor blockade. Sensory and motor blockade was also prolonged. The post operative analgesia was enhanced in group RN with low visual analogue scale score (VAS score). Haemodynamic stability was well maintained without any incidence of adverse effects.

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This page is a summary of: Effects of intrathecal Nalbuphine as an Adjuvant to Ropivacaine in Patients undergoing Transurethral Resection of Prostate, Indian Journal of Anaesthesia and Analgesia, January 2018, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.5818.13.
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