COMPARISON OF INTRATHECAL NALBUPHINE AND FENTANYL AS ADJUVANTS TO BUPIVACAINE IN SPINAL ANESTHESIA IN PATIENTS UNDERGOING LOWER LIMB SURGERIES

Authors

  • VIRENDRA KISHOR NIMBALKAR Department of Anaesthesiology and Critical Care, Silchar Medical College and Hospital, Silchar, Assam, India. https://orcid.org/0009-0002-9603-2316
  • SUNEETA DUTTA Department of Anaesthesiology and Critical Care, Silchar Medical College and Hospital, Silchar, Assam, India.
  • POONAM SHARMA Department of Anaesthesiology and Critical Care, Silchar Medical College and Hospital, Silchar, Assam, India.
  • SOMA PAUL Department of Anaesthesiology and Critical Care, Silchar Medical College and Hospital, Silchar, Assam, India

DOI:

https://doi.org/10.22159/ajpcr.2024v17i12.53029

Keywords:

Spinal anesthesia,, Fentanyl, Nalbuphine,, Sensory block, Motor block

Abstract

Objective: The objective of this study is to compare nalbuphine 0.5 mg and fentanyl 25 μg when used as an adjuvant to 0.5% bupivacaine heavy in spinal anesthesia for their effect on the sensory block, motor block, and post-operative analgesia.

Methods: After fulfillment of inclusion criteria and after obtaining informed written consent from patients, a group of a total of 80 patients was enrolled and divided in GRP-F and GRP-N equally. (1) Group F: Patients received diluted 25 μg of fentanyl with 3 mL (15 mg) of 0.5% hyperbaric bupivacaine. (2) Group N: Patients received diluted 0.5 mg of nalbuphine with 3 mL (15 mg) of 0.5% hyperbaric bupivacaine.

Results: The duration of sensory block and motor block was significantly longer in GRP-F than GRP-N. Post-operative analgesia was comparable in both groups with minimal side effects.

Conclusion: Intrathecal fentanyl in post-operative period was found to be significantly better than nalbuphine when used as an adjuvant therapy with 0.5% hyperbaric bupivacaine in elective lower limb surgeries with insignificant adverse effects like hypotension, nausea, and vomiting.

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References

Lee YY, Muchhal K, Chan CK, Cheung AS. Levobupivacaine and fentanyl for spinal anaesthesia: A randomized trial. Eur J Anaesthesiol. 2005 Dec;22(12):899-903. doi: 10.1017/S0265021505001523, PMID 16318658

Bandi E, Weeks S, Carli F. Spinal block levels and cardiovascular changes during post-cesarean transport. Can J Anaesth. 1999 Aug;46(8):736-40. doi: 10.1007/BF03013908, PMID 10451132

Operater N. Spinal Anesthesia; 2018. Available from: https://www. nysora.com/techniques/neuraxial-and-perineuraxial-techniques/spinal-anesthesia-2 [Last accessed on 2024 Jul 15 ]

Wang JK, Nauss LA, Thomas JE. Pain relief by intrathecally applied morphine in man. Anesthesiology. 1979 Feb;50(2):149-51. doi: 10.1097/00000542-197902000-00013, PMID 373503

Fentanyl Versus Nalbuphine as Adjuvant to Spinal Bupivacaine for Caesarean Delivery-a Comparative Study. Available from: https:// www.worldwidejournals.com/paripex/article/fentanyl-versus [Last accessed on 2024 Aug 20].

Miller RD, editor. Miller’s Anesthesia. 7th ed. Philadelphia, PA: Churchill Livingstone/Elsevier; 2010. p. 2.

Stoelting RK, Hillier SC. Pharmacology Physiology in Anesthetic Practice. 4th ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2006.

Srinivasaiah M, Padmaraju D, Gadiraju S, Nidiginti B. Comparison of nalbuphine and fentanyl as adjuvants to bupivacaine in unilateral spinal anaesthesia in patients undergoing lower limb orthopaedic surgeries. Indian J Clin Anaesth. 2022;9(2):169-73. doi: 10.18231/j.ijca.2022.035

Gupta K, Rastogi B, Gupta PK, Singh I, Bansal M, Tyagi V. Intrathecal nalbuphine versus intrathecal fentanyl as adjuvant to 0.5% hyperbaric bupivacaine for orthopedic surgery of lower limbs under subarachnoid block: A comparative evaluation. Indian J Pain. 2016 May 1;30(2):90-5. doi: 10.4103/0970-5333.186463

Bindra TK, Kumar P, Jindal G. Postoperative analgesia with intrathecal nalbuphine versus intrathecal fentanyl in cesarean section: A double-blind randomized comparative study. Anesth Essays Res. 2018 Apr 1;12(2):561-5. doi: 10.4103/aer.AER_41_18, PMID 29962635

Ahmed F, Narula H, Khandelwal M, Dutta D. A comparative study of three different doses of nalbuphine as an adjuvant to intrathecal bupivacaine for postoperative analgesia in abdominal hysterectomy. Indian J Pain. 2016 Jan 1;30(1):23-8. doi: 10.4103/0970-5333.173457

Published

07-12-2024

How to Cite

VIRENDRA KISHOR NIMBALKAR, SUNEETA DUTTA, POONAM SHARMA, and SOMA PAUL. “COMPARISON OF INTRATHECAL NALBUPHINE AND FENTANYL AS ADJUVANTS TO BUPIVACAINE IN SPINAL ANESTHESIA IN PATIENTS UNDERGOING LOWER LIMB SURGERIES”. Asian Journal of Pharmaceutical and Clinical Research, vol. 17, no. 12, Dec. 2024, pp. 92-96, doi:10.22159/ajpcr.2024v17i12.53029.

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