Abstract
Background: Opioids have been used as additives to bupivacaine in spinal block to enhance their action and analgesia. The aim of the study was to assess the effectiveness of adding intrathecal nalbuphine or fentanyl as an adjuvant to bupivacaine in spinal anesthesia for patients undergoing the transurethral resection of the prostate (TURP). This is a single-center, prospective, double-blind, randomized study. Materials and Methods: Sixty men (40–80 years) undergoing TURP received an intrathecal injection with 2.5 mL of 0.5% hyperbaric bupivacaine with fentanyl 25 µg (Group 1) or nalbuphine hydrochloride 0.8 mg (Group 2) in this prospective, randomized, double-blind study. The onset and duration of sensory and motor block, hemodynamic parameters, and incidence of adverse effects were compared between the groups. Results: Patients in the nalbuphine group reported significantly prolonged sensory block (198.60 ± 16.8min) compared to patients in the fentanyl group (185.40 ± 22.2min), (P < 0.001). Similarly, patients in the nalbuphine group had a longer motor block (210.60 ± 19.8min) in comparison to those in the fentanyl group (194.40 ± 21min; P < 0.001). Intraoperative hemodynamic variability was comparable in both the groups. Postoperative pain was significantly higher in the fentanyl group (80%) as compared to the nalbuphine group (13.3%) (P < 0.001). Conclusion: Intrathecal nalbuphine is a safe and valuable alternative to intrathecal fentanyl for spinal anesthesia.
Published Version
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