Comparison of Nalbuphine V/S Fentanyl as Intrathecal Adjuvant to Hyperbaric Bupivacaine in Orthopedic Lower Limb Surgeries

Abstract

Aims: To compare intrathecal nalbuphine v/s fentanyl added to 0.5% hyperbaric bupivacaine for perioperative anaesthesia and postoperative analgesia in patients undergoing lower limb orthopaedic surgery. Settings and Design: Single centre, prospective, randomized double blind controlled interventional study in patients posted for lower limb orthopaedic surgery. Methods and Material: 90 patients posted for elective orthopaedic lower limb surgeries under spinal anaesthesia were randomly divided into three groups of 30 each. Group B with 0.5ml saline, group F with 50 microgram fentanyl and group N with 1 mg nalbuphine as adjuvants to 0.5% hyperbaric bupivacaine. Block characteristics, hemodynamic parameters, duration of analgesia and advesre effects were monitored. Statistical analysis used: The collected data were analysed by one- way ANOVA and results were obtained in form of mean and standard deviation. The probability value p < 0.05 is considered as statistically significant. Results: Onset of sensory blockade in group N, F and G was 305.67 ±19.42, 292 ± 14.48 and 290 ± 18.36 seconds respectively. Duration of motor block Group N is higher than the Group F & Group B & it is statistically significant (191±19.31, 164.37±7.05 and 161.6 ±6.07 minutes respectively). Regression of sensory level is prolonged in Group N in comparison to Group F and B (300.13 ± 14.69, 181.37±7.92 and 178.97±7 minutes respectively). Duration of analgesia was 408 ± 21.44 and 391.93 ± 25.37 and 383.27 ± 19.75 minutes in group N and group F and group B respectively. Conclusion: Nalbuphine providing longer duration of motor block and analgesia compared to fentanyl can act as an effective alternate adjuvant in spinal anaesthesia.