A Critical Evaluation of an Effect of Nalbuphine as an Adjuvant to Bupivacaine for Ultrasound Guided Interscalene Brachial Plexus Block
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2018, Vol 5, Issue 6
Abstract
Context: The use of Brachial plexus block under Ultrasound guidance for Anesthesia has increased recently. Various adjuvants are added to enhance the analgesic effect of local anesthetic agents namely opioids, alpha 2 agonist, dexamethasone, etc. Aim: The aim of this study was to evaluate the effect of analgesic efficacy of nalbuphine as an adjuvant to 0.5% bupivacaine for interscalene brachial plexus block. Settings and Design: This is a prospective randomized double blind control study conducted in Melmaruvathur Adhiparasakthi Institute of Medical Science & Research over a period of one year from June 2016 to June 2017. Methods and Material: Sixty patients of ASA I and II undergoing elective shoulder surgery under Ultrasound guided Interscalene brachial plexus block were randomly allocated into two groups of thirty patients each to receive either 20mL of 0.5% bupivacaine with 1 mL normal saline ( Group I-Bupivacaine with control group) or 20mL of 0.5% bupivacaine with 1 mL of Nalbuphine 10mg (Group II- Bupivacaine with Nalbuphine). Onset and duration of sensory and motor block and duration of postoperative analgesia were observed. Statistical analysis used: Statistical analysis was performed using appropriate test with Graphic prism 5.0 software. Results: Addition of Nalbuphine with bupivacaine has faster onset of sensory and motor block and enhanced duration of sensory motor block compared to bupivacaine alone with statistically significant difference (p<0.0001). Nalbuphine prolongs the duration of analgesia significantly (p<0.0001). None of the patients experienced any adverse hemodynamic changes and complications. Conclusion: The present study explains that Nalbuphine 10 mg added to 0.5% bupivacaine in interscalene brachial plexus block has significant increase in the duration of analgesia with no adverse effects.
Authors and Affiliations
Anbu Muruga Raj Annamalai
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