Abstract
Background: Spinal anaesthesia is a commonly employed technique which provides safe, effective, low cost surgical anesthesia with good post-operative analgesia. Nalbuphine is a semi synthetic opioid with mixed antagonist and k agonist properties. In present study we have compared 0.8mg vs 1.4mg of Intrathecal inj. Nalbuphine with inj. bupivacaine heavy 0.5% 3.5cc to determine the most optimal dose for effective anaesthesia and maximum postoperative analgesia in lower abdominal surgeries. We also observed about the common side effects that occur with opioids like, pruritus, nausea, vomiting, sedation. Material and Methods: Patients were randomly allocated into two groups of 30 participants each. They received either nalbuphine 0.8 mg (group A) or nalbuphine 1.4 mg (group B) diluted upto 0.5ml with normal saline, mixed with 17.5 mg of hyperbaric bupivacaine 0.5% (3.5 ml). The onset of sensory blockade, onset of motor blockage, duration of sensory blockade, two-segment regression time from highest level of sensory blockade and duration of motor blockade were recorded following procedure. Results: In this study, we found that intrathecal injection Nalbuphine combined with intrathecal bupivacaine provides faster onset of sensory and motor blockage along with intraoperative hemodynamic stability. Addition of 1.4 mg intrathecal Nalbuphine in comparison with 0.8 mg provides better postoperative analgesia. The duration of sensory and motor blockade were increased without significantly increasing the incidence of side effects such as sedation, pruritus, nausea/vomiting and respiratory depression. Conclusion: In conclusion, Intrathecal Nalbuphine (1.4mg) added to Intrathecal Bupivacaine 0.5% heavy (17.5mg) provides prolonged postoperative analgesia without increasing risk of side effects. Further studies are required to determine optimal dosage of intrathecal Nalbuphine.
Highlights
Spinal anaesthesia is a very commonly used anaesthesia technique for various lower abdominal and lower limb surgeries
In this study, we found that intrathecal injection Nalbuphine combined with intrathecal bupivacaine provides faster onset of sensory and motor blockage along with intraoperative hemodynamic stability
Previous studies have shown that Intrathecal administration of Nalbuphine produced a significant analgesia accompanied by minimal pruritis and respiratory depression
Summary
Spinal anaesthesia is a very commonly used anaesthesia technique for various lower abdominal and lower limb surgeries. This approach has various advantages like cost effectiveness, better performance, enhanced margin of safety, and helps in providing good post-operative analgesia. Bupivacaine heavy 0.5% 3.5cc to establish the most effective dose for maximum postoperative analgesia in lower abdominal and lower limb surgeries. We observed the common side effects that occur with opioids like, pruritus, nausea, vomiting, sedation and respiratory depression. Bupivacaine heavy 0.5% 3.5cc to determine the most optimal dose for effective anaesthesia and maximum postoperative analgesia in lower abdominal surgeries. Conclusion: In conclusion, Intrathecal Nalbuphine (1.4mg) added to Intrathecal Bupivacaine 0.5% heavy (17.5mg) provides prolonged postoperative analgesia without increasing risk of side effects. Further studies are required to determine optimal dosage of intrathecal Nalbuphine
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