To assess the efficacy of injection nalbuphine as an adjuvant to intrathecal bupivacaine in endoscopic urological surgeries for prolongation of postoperative analgesia

Abstract

Spinal anesthesia has a quicker onset of action and completely blocks all motor functions. It requires less local anesthetic and has a reduced rate of failed blocks hence the preferred anesthetic method for lower abdomen procedures is spinal anesthesia. Intrathecal local anesthetics benefit from adjuvant medications by extending postoperative analgesia and thus improving the sensory blockade's duration and quality. Intrathecal opioids and local anesthetics work together synergistically to increase the sensory block while decreasing the sympathetic block. Adjuvants to local anesthetics for intrathecal administration have certain benefits, including lowered local anesthetic medication dose, improved hemodynamic stability, and fewer adverse effects. The opioid medication nalbuphine has a kappa agonist and mu antagonist action that reduces pain without having many negative side effects. It acts on opoid receptor as both an agonist and an antagonist to offer visceral nociception with a moderately powerful analgesic. Almost all general anesthesia and regional anesthesia treatments employ it. To cause analgesia, nalbuphine adheres to k receptors. Perioperative analgesia is also improved when administered as an adjuvant to bupivacaine. It is a hybrid which has both agonist and antagonist actions that increases and attenuates the effects of -opioids. Numerous researchers have investigated the properties of intrathecal nalbuphine. This study's objective to determine the efficacy of injectable nalbuphine as an augmentation to intrathecal bupivacaine in endoscopic urological surgeries to extend post operative analgesia.