Comparison of nalbuphine and fentanyl as adjuvants to bupivacaine in unilateral spinal anaesthesia in patients undergoing lower limb orthopaedic surgeries

Abstract

Unilateral spinal anaesthesia is a technique used to avoid hemodynamic changes and early recovery. Adjuvants are added to prolong post operative analgesia, this study was done to compare nalbuphine (0.8mg) and fentanyl (20µg) as adjuvants to 0.5% bupivacaine Heavy in unilateral spinal anaesthesia for patients undergoing lower limb orthopaedic surgeries. Randomized double blind study in patients posted for lower limb orthopaedic surgery in a teritiary care center.Unilateral spinal anaesthesia was given to 68 eligible patients undergoing lower limb orthopaedic surgery with nalbuphine (0.8mg) and fentanyl (20µg) as adjuvants to 0.5% bupivacaine Heavy. Block characterstics, unilaterality, hemodynamic changes and recovery were noted. Independent sample t-test was used to compare continuous variables with normal distribution and chi square test for categorical variablesUnilateral block was seen in 60 of 68 patients enrolled. Time to achieve T 10 level was comparable between both the groups in nalbuphine and fentanyl group (4.33±0.99 and 4.77 ± 0.89 respectively). Duration of sensory block was significantly lesser in nalbuphine group as compared to fentanyl group (170.67±15.34 and 178.83±15.04 respectively). However, there was no significant difference in duration of analgesia, 265.17 ± 17.73 in nalbuphine group and 260.23 ±31.03 in fentanyl group (p=0.45).Nalbuphine due to its easy availability can be used as effective alternative to fentanyl as adjuvant in unilateral spinal anaesthesia.

Comparison of Postoperative Analgesia Between Intrathecal Nalbuphine and Intrathecal Fentanyl in Infraumbilical Surgeries: A Double-Blind Randomized Controlled Trial

“…Similar results were obtained by Garg et al [ 12 ] and Gupta et al [ 13 ] who inferred that the mean time for the first rescue analgesic request in the nalbuphine group was significantly better when compared to the fentanyl group. However, there were a few divergences from our observations from Srinivasaiah et al [ 14 ] and Gomaa et al [ 15 ] who found no significant difference in the duration of analgesia between nalbuphine and fentanyl. The main presumption for such a divergence in findings could be attributed to a lesser dose of nalbuphine employed in both trials in contrast to us.…”