A COMPARATIVE STUDY TO EVALUATE EFFICACY OF ADMINISTRATION OF NALBUPHINE AS ADJUVANT TO HYPERBARIC BUPIVACAINE INTRATHECALLY IN LOWER LIMB SURGERIES

Dr. Jyoti P Deshapande, Dr. Priyanka S Shalu, Dr. Girish Saundatikar

Abstract


Background and aims: Unilateral spinal anesthesia is preferred for surgery limited to one lower limb but the duration of action is short. This randomized study was aimed to evaluate the efficacy of intrathecal nalbuphine for prolonging duration of spinal anesthesia. Material and methods: A total of 60 patients with American society of Anesthesiologist (ASA) physical status I and II, aged 25-35 years, scheduled for elective lower limb orthopedic surgery under spinal anesthesia were randomly allocated into two groups of 30 patients each; Group N (receiving 0.5% hyperbaric bupivacaine 10mg with Inj. Nalbuphine 40 ug in 0.5 ml NS) and Group C (receiving 0.5% hyperbaric bupivacaine 10mg with 0.5ml NS). Both the groups were compared for onset and duration of blockade, duration of analgesia and incidence of block unilaterality. Results: Among the groups, patients’ demographic profile, onset of sensory level up to T12 (P value >0.05) and difference between time for achieving complete motor block was comparable. The difference in time to regression of block to L2 was highly significant, (P value < 0.0001). In group N there was prolonged duration of motor block (P value<0.0001) and analgesia (P value < 0.0001) than group C. Campbell  sedation score was 1 in group  N and 0 in group C (P value = 0.3176 ). The incidence of block unilaterality was comparable: group N (76%) and group C (74%) [P value 0.8592]. Conclusion: Nalbuphine with bupivacaine in unilateral spinal anesthesia provides predominant unilaterality, enhanced postoperative analgesia, stable hemodynamics and minimal side effects.


Keywords


Unilateral spinal anesthesia, LOWER LIMB, Subarachnoid

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