Table of Contents

2018 Month : September Volume : 7 Issue : 37 Page : 4084-4087

INTRATHECAL NALBUPHINE IN DIFFERENT DOSES AS AN ADJUVANT TO SUBARACHNOID BLOCK.

Ashoka Kumar Panigrahi1, Bimal Krushna Panda2, Alok Kumar Panigrahy3, Kulwant Lakra4, Sanjeeb Kumar Mishra5

Corresponding Author:
Dr. Bimal Krushna Panda,
Adarsha Nagar, HLO Colony,
Sambalpur-768001, Odisha, India.
E-mail: drbimalpanda@gmail.com

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.

KEY WORDS

Bupivacaine, Nalbuphine, Intrathecal.

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