Abstract PR503

Othman, Safenas; Budiman, Maryam; Masdar, Azlina; Izaham, Azarinah; Zainuddin, Muhammad Zurrusydi; Manap, Norsidah Abdul

doi:10.1213/01.ane.0000492887.95348.c6

Cited by 1 publication

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“…Entropy is used to monitor sedation (Kwon et al 2012) and depth of anaesthesia (Varma et al 2014). An extensive literature search revealed few studies on intrathecal fentanyl using entropy (Syed Othman et al 2016, Varma et al 2014), but scarce sources on nalbuphine. Therefore, this study aimed to compare the analgesic efficacy (primary outcome) and effect on entropy (secondary outcome) between nalbuphine and fentanyl as adjuvants added to 3 mL of 0.5% hyperbaric bupivacaine for the subarachnoid block in lower limb surgery.…”

Section: Introductionmentioning

confidence: 99%

Comparison of fentanyl and nalbuphine as adjuvants to intrathecal 0.5% bupivacaine in lower limb surgeries: A randomised double-blind prospective study

Geetha

Rudrakshala

Kar

et al. 2022

Journal of Perioperative Practice

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Introduction: Local anaesthetics used in spinal anaesthesia have a limited duration of action. To prolong postoperative analgesia, adjuvants, mainly opioids, are used. As µ agonist drugs have side effects, other receptor agonists are considered. Nalbuphine is a safe and effective kappa agonist adjuvant. Aim: To compare the analgesic efficacy between fentanyl and nalbuphine adjuvants added to 3 mL of 0.5% intrathecal hyperbaric bupivacaine. Materials and Methods: This prospective, double-blind, comparative study was conducted in 60 patients of either sex belonging to the American Society of Anesthesiologists classes I and II aged 18–65 years undergoing lower limb surgery with entropy monitoring, randomly allocated into two groups. Group F (n = 30) received 0.5% hyperbaric bupivacaine (3 mL) + 25 µg (0.5 mL) fentanyl. Group N (n = 30) received 0.5% hyperbaric bupivacaine (3 ml) + 0.8 mg (0.5 mL) nalbuphine intrathecally. Hemodynamics, entropy, motor and sensory block characteristics, and complications were noted. Results: The nalbuphine group had a significantly longer two-segment regression time of sensory blockade and extended analgesia duration than the fentanyl group. Haemodynamics, entropy, time for onset of sensory and motor blockade and adverse effects were comparable in both groups. Conclusion: Nalbuphine prolongs sensory blockade and postoperative analgesia duration with minimal side effects and is a safe intrathecal adjuvant.

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