English

Abstract

BACKGROUND Managing pain and stress during and after any surgical procedure is a real challenge and a matter of concern for both surgeons and anaesthesiologists. Various analgesics like tramadol and nalbuphine have been used as adjuncts to anaesthetic agents with different efficacy. We wanted to do a comparative assessment of efficacy between intravenous (IV) administration of tramadol and nalbuphine in managing perioperative pain and stress. METHODS This was a single blinded randomised control trial, which included 60 female adult patients in the age group of 30 - 50 years who were posted for surgical procedures like elective vaginal hysterectomy under spinal block. Patients with comorbidities like diabetes, obesity, hypertension, impaired pulmonary function, recent history of medication with selective serotonin reuptake inhibitors were excluded from the study. Study participants were divided into two groups - group tramadol (TR) and group nalbuphine (NA) with 30 patients in each group. Group TR was given tramadol 0.5 - 0.7 mg / Kg whereas group NA was given nalbuphine 0.1 - 0.2 mg / Kg after an hour of spinal block. Both drugs were administered intravenously. Midazolam 0.01 - 0.05 mg / Kg was administered intravenously within first hour of surgery for sedation. Pain, stress and sedation score, requirement of rescue analgesics and occurrence of adverse drug reactions (ADRs) over 12 hours postoperatively were compared. RESULTS Significant lowering of pain and stress scores and higher sedation score was observed in group NA in comparison to group TR. The requirement of rescue analgesic and occurrence of side effects like nausea and vomiting were less in group NA. CONCLUSIONS Intravenous administration of nalbuphine was found to be more effective in perioperative control of pain and stress and can be a better choice than intravenous tramadol. KEYWORDS Efficacy, Tramadol, Nalbuphine, Rescue Analgesia