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 70
- Downloads 0
Assessment of Common Risk Factors Between Oral Diseases and Non-communicable Diseases in a Hospital-based Population in Kerala, India- A Cross-sectional Study
ABSTRACT Introduction: Non-Communicable Diseases (NCDs) have assumed epidemic proportions around the world. Oral diseases also pose tremendous physical and emotional burden on the people. Both these conditions (NCDs and...
Retroperitoneal Lipoblastoma-A Rare Entity
ABSTRACT Lipoblastomas are uncommon tumours which can achieve enormous size and volumes occurring in young paediatric population predominantly. Retroperitoneal locations of these tumours are very rare and only a few case...
Bilateral Double Maxillary Paramolars: A Rare Case Report
Paramolars are rare supernumerary molars occurring buccally or lingually/palatally near the molar row. They may cause complications such as caries, periodontal disease and delay or prevention eruption of permanent teeth....
Comment on “Postoperative Pain and Flare-Ups: Comparison of Incidence between Single and Multiple Visit Pulpectomy in Primary Molars”
Letter to Editor
Tumour Budding and MMP-2 Expression in Breast Invasive Ductal Carcinoma
ABSTRACT Introduction: Breast cancer is a major cause of cancer death among females. Tumour buds are clusters of undifferentiated malignant cells (one cell to less than or equal to five cells) at the invasive front of a...