Abstract
Background: Nalbuphine is a derivative of 14-hydroxymorphine which is a strong analgesic with mixed k agonist and μ antagonist. Nalbuphine was studied several times as adjuvant to local anesthetics in spinal, epidural and local intravenous block. The aim of this study was to evaluate the effect of nalbuphine as an adjuvant to local anesthetics in supraclavicular brachial plexus block. Patients and Methods: Fifty-six patients undergoing elective forearm and hand surgery under supraclavicular brachial plexus block were allocated randomly into one of two groups of 28 patients each to receive either 25 ml (0.5%) bupivacaine with 1 ml of NS or 25 ml (0.5%) bupivacaine with 1 ml (20 mg) nalbuphine. Onset time and duration of both sensory and motor block, and post-operative analgesia were observed. Result: Nalbuphine group showed significant increase in the duration of motor block (412.59 ± 18.63), when compared to control group (353.70 ± 29.019) p-value < 0.001, also, there was significant increase in sensory duration in nalbuphine group (718.14 ± 21.04) when compared to control group (610.18 ± 26.33) p-value < 0.001, without affecting the onset time of the blockade. And also, there was a significant increase in the duration of analgesic effect in nalbuphine group (835.18 ± 42.45) when compared to control group (708.14 ± 54.57) p-value < 0.001. Conclusion: The present study demonstrates that addition of 20 mg nalbuphine to bupivacaine in supraclavicular brachial plexus block is associated with significant increase in the duration of both sensory and motor block and also prolong the duration of analgesia.
Highlights
Nalbuphine is a derivative of 14-hydroxymorphine which is a strong analgesic with mixed k agonist and μ antagonist
The aim of this study was to evaluate the effect of nalbuphine as an adjuvant to local anesthetics in peripheral nerve block, so we compare the effect of a combination of nalbuphine and bupivacaine versus bupivacaine alone in supraclavicular brachial plexus block for the patients undergoing elective upper limb surgeries
The result of our study showed that addition of 20 mg nalbuphine to 0.5% bupivacaine for supraclavicular brachial plexus block results in significant increase in the duration of motor block (412.59 ± 18.63), when compared to control group (353.70 ± 29.019), there was significant increase in sensory duration in nalbuphine group (718.14 ± 21.04) when compared to control group (610.18 ± 26.33), without affecting the onset time of the blockade
Summary
Nalbuphine is a derivative of 14-hydroxymorphine which is a strong analgesic with mixed k agonist and μ antagonist. The aim of this study was to evaluate the effect of nalbuphine as an adjuvant to local anesthetics in supraclavicular brachial plexus block. Conclusion: The present study demonstrates that addition of 20 mg nalbuphine to bupivacaine in supraclavicular brachial plexus block is associated with significant increase in the duration of both sensory and motor block and prolong the duration of analgesia. Brachial plexus block is most commonly used regional nerve block of the upper extremity, which avoids the undesired effect of anesthetic drugs used during general anesthesia and the stress of laryngoscopy and tracheal intubation. The supraclavicular brachial plexus block has many advantages over other approaches to brachial plexus block It provides complete and reliable anesthesia for upper limb surgery. It is performed at the level of the trunk where the plexus is presented most compactly [2]
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