A prospective, double-blind dose-ranging study of intrathecal nalbuphine in the lower abdominal and lower limb surgeries

Background: Nalbuphine is a synthetic opioid with mixed agonist-antagonist action, used as an adjuvant with intrathecal bupivacaine to prolong postoperative analgesia. However, only a few studies so far have quantified the optimal intrathecal nalbuphine dose. Our aim was to compare the relative effe...

Full description

Bibliographic Details
Main Authors: Sandip Roy Basunia, Suman Chattopadhyay, Aditi Das, Baishaki Laha, Debasish Bhar, Rita Pal
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2016-01-01
Series:Indian Journal of Pain
Subjects:
Online Access:http://www.indianjpain.org/article.asp?issn=0970-5333;year=2016;volume=30;issue=3;spage=198;epage=203;aulast=Basunia
_version_ 1818535210282647552
author Sandip Roy Basunia
Suman Chattopadhyay
Aditi Das
Baishaki Laha
Debasish Bhar
Rita Pal
author_facet Sandip Roy Basunia
Suman Chattopadhyay
Aditi Das
Baishaki Laha
Debasish Bhar
Rita Pal
author_sort Sandip Roy Basunia
collection DOAJ
description Background: Nalbuphine is a synthetic opioid with mixed agonist-antagonist action, used as an adjuvant with intrathecal bupivacaine to prolong postoperative analgesia. However, only a few studies so far have quantified the optimal intrathecal nalbuphine dose. Our aim was to compare the relative effectiveness of three doses of intrathecal nalbuphine to determine the optimum dose which prolonged analgesia with minimal side effects. Settings and Design: This was a prospective, randomized, double-blind study. Subjects and Methods: Eighty American Society of Anesthesiologists I and II patients undergoing elective lower abdominal and lower limb surgeries under subarachnoid block were randomly allocated to four groups (A, B, C, and D of twenty patients each) to receive 0.5 ml normal saline or 0.8, 1.2, and 1.6 mg nalbuphine added to 0.5% hyperbaric bupivacaine 15 mg. The onset of sensory and motor blockade, two-segment regression time of sensory blockade, duration of motor blockade, duration of analgesia, visual analog scale pain score, and side effects were compared between these groups. Results: Two-segment regression time of sensory blockade and duration of effective analgesia were prolonged in both Group C (1.2 mg nalbuphine) and Group D (1.6 mg nalbuphine) compared to Groups A and B (P < 0.05), but the incidence of side effects was significantly higher in Group D (P < 0.05). Conclusion: Nalbuphine 1.2 mg is the optimum intrathecal dose which prolongs postoperative analgesia without increased side effects.
first_indexed 2024-12-11T18:21:47Z
format Article
id doaj.art-b6da19427fbc41d9a93f029292595836
institution Directory Open Access Journal
issn 0970-5333
language English
last_indexed 2024-12-11T18:21:47Z
publishDate 2016-01-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Indian Journal of Pain
spelling doaj.art-b6da19427fbc41d9a93f0292925958362022-12-22T00:55:14ZengWolters Kluwer Medknow PublicationsIndian Journal of Pain0970-53332016-01-0130319820310.4103/0970-5333.198060A prospective, double-blind dose-ranging study of intrathecal nalbuphine in the lower abdominal and lower limb surgeriesSandip Roy BasuniaSuman ChattopadhyayAditi DasBaishaki LahaDebasish BharRita PalBackground: Nalbuphine is a synthetic opioid with mixed agonist-antagonist action, used as an adjuvant with intrathecal bupivacaine to prolong postoperative analgesia. However, only a few studies so far have quantified the optimal intrathecal nalbuphine dose. Our aim was to compare the relative effectiveness of three doses of intrathecal nalbuphine to determine the optimum dose which prolonged analgesia with minimal side effects. Settings and Design: This was a prospective, randomized, double-blind study. Subjects and Methods: Eighty American Society of Anesthesiologists I and II patients undergoing elective lower abdominal and lower limb surgeries under subarachnoid block were randomly allocated to four groups (A, B, C, and D of twenty patients each) to receive 0.5 ml normal saline or 0.8, 1.2, and 1.6 mg nalbuphine added to 0.5% hyperbaric bupivacaine 15 mg. The onset of sensory and motor blockade, two-segment regression time of sensory blockade, duration of motor blockade, duration of analgesia, visual analog scale pain score, and side effects were compared between these groups. Results: Two-segment regression time of sensory blockade and duration of effective analgesia were prolonged in both Group C (1.2 mg nalbuphine) and Group D (1.6 mg nalbuphine) compared to Groups A and B (P < 0.05), but the incidence of side effects was significantly higher in Group D (P < 0.05). Conclusion: Nalbuphine 1.2 mg is the optimum intrathecal dose which prolongs postoperative analgesia without increased side effects.http://www.indianjpain.org/article.asp?issn=0970-5333;year=2016;volume=30;issue=3;spage=198;epage=203;aulast=BasuniaHyperbaric bupivacaineintrathecalnalbuphinespinal anesthesia
spellingShingle Sandip Roy Basunia
Suman Chattopadhyay
Aditi Das
Baishaki Laha
Debasish Bhar
Rita Pal
A prospective, double-blind dose-ranging study of intrathecal nalbuphine in the lower abdominal and lower limb surgeries
Indian Journal of Pain
Hyperbaric bupivacaine
intrathecal
nalbuphine
spinal anesthesia
title A prospective, double-blind dose-ranging study of intrathecal nalbuphine in the lower abdominal and lower limb surgeries
title_full A prospective, double-blind dose-ranging study of intrathecal nalbuphine in the lower abdominal and lower limb surgeries
title_fullStr A prospective, double-blind dose-ranging study of intrathecal nalbuphine in the lower abdominal and lower limb surgeries
title_full_unstemmed A prospective, double-blind dose-ranging study of intrathecal nalbuphine in the lower abdominal and lower limb surgeries
title_short A prospective, double-blind dose-ranging study of intrathecal nalbuphine in the lower abdominal and lower limb surgeries
title_sort prospective double blind dose ranging study of intrathecal nalbuphine in the lower abdominal and lower limb surgeries
topic Hyperbaric bupivacaine
intrathecal
nalbuphine
spinal anesthesia
url http://www.indianjpain.org/article.asp?issn=0970-5333;year=2016;volume=30;issue=3;spage=198;epage=203;aulast=Basunia
work_keys_str_mv AT sandiproybasunia aprospectivedoubleblinddoserangingstudyofintrathecalnalbuphineinthelowerabdominalandlowerlimbsurgeries
AT sumanchattopadhyay aprospectivedoubleblinddoserangingstudyofintrathecalnalbuphineinthelowerabdominalandlowerlimbsurgeries
AT aditidas aprospectivedoubleblinddoserangingstudyofintrathecalnalbuphineinthelowerabdominalandlowerlimbsurgeries
AT baishakilaha aprospectivedoubleblinddoserangingstudyofintrathecalnalbuphineinthelowerabdominalandlowerlimbsurgeries
AT debasishbhar aprospectivedoubleblinddoserangingstudyofintrathecalnalbuphineinthelowerabdominalandlowerlimbsurgeries
AT ritapal aprospectivedoubleblinddoserangingstudyofintrathecalnalbuphineinthelowerabdominalandlowerlimbsurgeries
AT sandiproybasunia prospectivedoubleblinddoserangingstudyofintrathecalnalbuphineinthelowerabdominalandlowerlimbsurgeries
AT sumanchattopadhyay prospectivedoubleblinddoserangingstudyofintrathecalnalbuphineinthelowerabdominalandlowerlimbsurgeries
AT aditidas prospectivedoubleblinddoserangingstudyofintrathecalnalbuphineinthelowerabdominalandlowerlimbsurgeries
AT baishakilaha prospectivedoubleblinddoserangingstudyofintrathecalnalbuphineinthelowerabdominalandlowerlimbsurgeries
AT debasishbhar prospectivedoubleblinddoserangingstudyofintrathecalnalbuphineinthelowerabdominalandlowerlimbsurgeries
AT ritapal prospectivedoubleblinddoserangingstudyofintrathecalnalbuphineinthelowerabdominalandlowerlimbsurgeries