A Comparative Study of Analgesic Effect of Intrathecal Nalbuphine and Fentanyl as Adjuvant in Lower Limb Orthopaedic Surgery
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 7
Abstract
Introduction: Intrathecal opioids when added to local anaesthetics decrease their dosage and provide haemodynamic stability. Nalbuphine is an agonist-antagonist and acts on kappa receptors providing analgesia. Aim: The study aims to compare the analgesic efficacy of fentanyl with that of two doses of nalbuphine when used with injection bupivacaine heavy in spinal anaesthesia. Materials and Methods: A randomised, double blinded, prospective study on 90 patients of ASA I and II undergoing lower limb orthopaedic surgery under subarachnoid block was done. Patients were randomly allocated into three groups (n=30). Each group received 12.5 mg of 0.5% of injection bupivacaine heavy along with either 25 µg of 0.5 ml fentanyl (Group F) or 0.8 mg of 0.5 ml nalbuphine (Group NL) or 1.6 mg of 0.5 ml nalbuphine (Group NH). Characteristics of sensory and motor blocks, haemodynamic changes, duration and quality of analgesia, adverse effects, sedation, VRS score and analgesic requirement were studied at different time interval intraoperatively and till 24 hours of block. Results: The duration of analgesia (in minute) was 441±119.69 in NL Group, 450±103.38 in NH Group and 300.0±88.53 in Group F (p=0.05). There was no significant difference regarding block characteristics and haemodynamic parameters. Total 24 hours analgesic requirement was titrated by analgesic score which was 2.25±0.7 (NH Group), 1.875±0.83 (NL Group) and 3.375±1.77 (F Group) p=0.0186 by ANOVA. The adverse effects of NL Group were least. Conclusion: There was no significant advantage of intrathecal fentanyl or 1.6 mg nalbuphine over low dose 0.8 mg nalbuphine
Authors and Affiliations
Shagufta Naaz, Usha Shukla, Swati Srivastava, Erum Ozair, Adil Asghar
Keywords
Related Articles
- EP ID EP356328
- DOI 10.7860/JCDR/2017/24385.10224
- Views 57
- Downloads 0
Iris Positioning Using a Grid Attached to a Spring Bow for a Custom Ocular Prosthesis
Eyes are among the first features of the face to be noticed. Loss of an eye due to congenital, traumatic or pathologic aetiologies causes disfigurement and loss of sensory feedback. It leaves a psychological impact on th...
Correlation of Echocardiography Findings with Intraoperative Findings in Infective Endocarditis Patients: A Prospective Cohort Study
ABSTRACT Introduction: Echocardiography plays an important role in the management of Infective Endocarditis (IE) but may be limited in some clinical situations. Lately, with arrival of novel hybrid imaging modalities, of...
Comparative Evaluation of the Antibacterial Efficacy of two different Formulations of Calcium hydroxide as Intracanal Medicaments against Enterococcus faecalis: An In vitro study
Introduction: Complete disinfection of the root canal system is necessary to ensure the success of the root canal treatment. Calcium hydroxide alone has shown to be ineffective against persistent intracanal infections. S...
Anaesthetic Considerations for Balloon Mitral Valvuloplasty in Pregnant Patient with Severe Mitral Stenosis: A Case Report and Review of Literature
Even though, the incidence of Mitral Stenosis (MS) has reduced grossly, it still remains a health problem in developing countries and is the most common rheumatic valvular lesion encountered in pregnant patients. The alr...
The Role of Serum Fibrinogen Level in the Diagnosis of Acute Appendicitis
Introduction: Acute appendicitis is the most common indication for emergent surgery and affects a wide range of patients at any age group. However, inspite of the presence of various imaging modalities, biochemical marke...