Abstract

A COMPARATIVE STUDY OF NALBUPHINE AND FENTANYL AS AN INTRATHECAL ADJUVANT TO 0.5% HYPERBARIC BUPIVACAINE

Tikam Chand, Arvind Bhalekar and Rajeev Kumar Dubey*

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Abstract

The combination of intrathecal opioids and local anaesthetics provide better analgesia than administration of individual drugs alone because these two drugs act at different sites. The present clinical study aims to compare the clinical efficiency of nalbuphine and fentanyl as an intrathecal adjuvant to 0.5% hyperbaric bupivacaine. The primary objectives included assessment of sensory and motor blockade characteristics and duration of postoperative analgesia. The secondary objectives were intraoperative hemodynamic changes, and incidence of side effects, if any (e.g. nausea, vomiting, hypotension and pruritis). This prospective, randomized, double‐blind, interventional study was approved by the Institutional Ethical Committee and written informed consent was obtained from all subjects. 100 patients of age between 18 to 65 years of age, scheduled for lower abdominal and lower limb surgery were randomly allocated into 2 groups: Group A (n=50) – Bupivacaine (0.5%) 2.5ml with fentanyl 0.5ml (25mcg) and Group B (n=50) – Bupivacaine (0.5%) 2.5ml with nalbuphine 0.8mg. The results show that addition of nalbuphine 0.8 mg to hyperbaric bupivacaine 0.5% (12.5mg) provides efficient and prolonged postoperative analgesia with minimum or no side effects (pruritus, nausea, vomiting, bradycardia, respiratory depression) than addition of fentanyl 25 mcg to same baricity and dose of bupivacaine.

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