AIMS AND OBJECTIVES: To find out the most effective dose of nalbuphine as adjuvant to spinal anaesthesia. To compare the three different doses and find out most optimum dose of nalbuphine with minimal side effects and maximum analgesic effect.
MATERIALS AND METHODS: We conducted prospective randomized double blinded controlled study with 120 ASA I and II patients who were undergoing lowerlimb orthopedic surgery under spinal anaesthesia. We randomly allocated four groups A,B,C to receive 0.4, 0.6,0.8 mg nalbuphine made up to 0.5 ml with distilled water and group D receive 0.5 ml of plain distilled water added to2.5ml of 0.5% hyperbaric bupivacaine (3ml) respectively. The onset of sensory block and motor block, duration of surgery, duration …show more content…
Nalbuphine 0,8 mg (group C) have prolonged duration of analgesia (table 2) but increased advere effects ( table 3). As regarding neurotoxicity of intrathecal nalbuphine , it used modern day practice more than 10 yrs without neurotoxicity(14).
Conclusion:
We concluded that intrathecal nalbuphine 0.6 mg added to 0.5% hyperbaric bupivacaine for spinal anaesthesia in patients undergoing lower limb orthopedic surgeries had prolonged duration of motor block and duration of analgesia without increased adverse effects. So we conclude that 0.6 mg of nalbuphine is better adjuvant to bupivacaine in spinal anaesthesia.
References :
1.veering B. Focus on adjuvants in regional anaesthesia. Euro anaesthesia . 2005;50: …show more content…
Nalbuphine : An autoradiographic opioid receptor binding profile in the central nervous system of an agonist/antagonist analgesic. J Pharmacol Exp Ther. 1988;244:391-402.
10. Fournier R , Gamulin Z , Macksay M, Van Gessel E. Intrathecal morphine versus nalbuphine for post operative pain relief after total hip replacement. Anaesthesiology. 1998;89;867.
11. Culebras X, Gaggero G, Zatloukal J, Kern C, Marti RA . Advantages of intrathecal nalbuphine, compared with intrathecal morphine, after cesarean delivery: An evalution of postoperative analgesia and adverse effects. Anesth Analg. 2000;91:601-5.
12. Tiwari AK. Tomar GS, Agrawal J. Intrathecal bupivacaine in comparision with a combination of nalbuphine and bupivacaine for subarachnoid block; a randomized prospective bouble blind study. Am J Ther 2013;6:592-5.
13. Mukherjee A. Pal A. Agrawal J, Mehrotra A. Dawar N. Intrathecal nalbuphine as an adjuvant to subarachnoid block: what is most effective dose? Anesth Essays Res 2011;5:171-5.
14. Rawal N , Nuutinen L, Raj PP, Lovering SL, Gobuty AH, Hargardine J, et al. Behavioral and histopathologic effects following intrathecal administration of butorphnol, sufentanil and nalbuphine in sheep. Anaesthesiology.
MATERIALS AND METHODS: We conducted prospective randomized double blinded controlled study with 120 ASA I and II patients who were undergoing lowerlimb orthopedic surgery under spinal anaesthesia. We randomly allocated four groups A,B,C to receive 0.4, 0.6,0.8 mg nalbuphine made up to 0.5 ml with distilled water and group D receive 0.5 ml of plain distilled water added to2.5ml of 0.5% hyperbaric bupivacaine (3ml) respectively. The onset of sensory block and motor block, duration of surgery, duration …show more content…
Nalbuphine 0,8 mg (group C) have prolonged duration of analgesia (table 2) but increased advere effects ( table 3). As regarding neurotoxicity of intrathecal nalbuphine , it used modern day practice more than 10 yrs without neurotoxicity(14).
Conclusion:
We concluded that intrathecal nalbuphine 0.6 mg added to 0.5% hyperbaric bupivacaine for spinal anaesthesia in patients undergoing lower limb orthopedic surgeries had prolonged duration of motor block and duration of analgesia without increased adverse effects. So we conclude that 0.6 mg of nalbuphine is better adjuvant to bupivacaine in spinal anaesthesia.
References :
1.veering B. Focus on adjuvants in regional anaesthesia. Euro anaesthesia . 2005;50: …show more content…
Nalbuphine : An autoradiographic opioid receptor binding profile in the central nervous system of an agonist/antagonist analgesic. J Pharmacol Exp Ther. 1988;244:391-402.
10. Fournier R , Gamulin Z , Macksay M, Van Gessel E. Intrathecal morphine versus nalbuphine for post operative pain relief after total hip replacement. Anaesthesiology. 1998;89;867.
11. Culebras X, Gaggero G, Zatloukal J, Kern C, Marti RA . Advantages of intrathecal nalbuphine, compared with intrathecal morphine, after cesarean delivery: An evalution of postoperative analgesia and adverse effects. Anesth Analg. 2000;91:601-5.
12. Tiwari AK. Tomar GS, Agrawal J. Intrathecal bupivacaine in comparision with a combination of nalbuphine and bupivacaine for subarachnoid block; a randomized prospective bouble blind study. Am J Ther 2013;6:592-5.
13. Mukherjee A. Pal A. Agrawal J, Mehrotra A. Dawar N. Intrathecal nalbuphine as an adjuvant to subarachnoid block: what is most effective dose? Anesth Essays Res 2011;5:171-5.
14. Rawal N , Nuutinen L, Raj PP, Lovering SL, Gobuty AH, Hargardine J, et al. Behavioral and histopathologic effects following intrathecal administration of butorphnol, sufentanil and nalbuphine in sheep. Anaesthesiology.