A Comparative Study of Analgesic Effect of Intrathecal Nalbuphine and Fentanyl as Adjuvant in Lower Limb Orthopaedic Surgery
Introduction: Intrathecal opioids when added to local anaesthetics decrease their dosage and provide haemodynamic stability. Nalbuphine is an agonist-antagonist and acts on kappa receptors providing analgesia. Aim: The study aims to compare the analgesic efficacy of fentanyl with that of two do...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2017-07-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/10224/24385_CE[Ra]_F(Sh)_PF1(SS_VT_NE)_PFA(NE_SS).pdf |
| _version_ | 1818503401164505088 |
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| author | Shagufta Naaz Usha Shukla Swati Srivastava Erum Ozair Adil Asghar |
| author_facet | Shagufta Naaz Usha Shukla Swati Srivastava Erum Ozair Adil Asghar |
| author_sort | Shagufta Naaz |
| collection | DOAJ |
| description | Introduction: Intrathecal opioids when added to local
anaesthetics decrease their dosage and provide haemodynamic
stability. Nalbuphine is an agonist-antagonist and acts on kappa
receptors providing analgesia.
Aim: The study aims to compare the analgesic efficacy of
fentanyl with that of two doses of nalbuphine when used with
injection bupivacaine heavy in spinal anaesthesia.
Materials and Methods: A randomised, double blinded,
prospective study on 90 patients of ASA I and II undergoing
lower limb orthopaedic surgery under subarachnoid block
was done. Patients were randomly allocated into three groups
(n=30). Each group received 12.5 mg of 0.5% of injection
bupivacaine heavy along with either 25 µg of 0.5 ml fentanyl
(Group F) or 0.8 mg of 0.5 ml nalbuphine (Group NL) or 1.6 mg
of 0.5 ml nalbuphine (Group NH). Characteristics of sensory
and motor blocks, haemodynamic changes, duration and
quality of analgesia, adverse effects, sedation, VRS score and
analgesic requirement were studied at different time interval
intraoperatively and till 24 hours of block.
Results: The duration of analgesia (in minute) was 441±119.69
in NL Group, 450±103.38 in NH Group and 300.0±88.53 in
Group F (p=0.05). There was no significant difference regarding
block characteristics and haemodynamic parameters. Total 24
hours analgesic requirement was titrated by analgesic score
which was 2.25±0.7 (NH Group), 1.875±0.83 (NL Group) and
3.375±1.77 (F Group) p=0.0186 by ANOVA. The adverse effects
of NL Group were least.
Conclusion: There was no significant advantage of intrathecal
fentanyl or 1.6 mg nalbuphine over low dose 0.8 mg
nalbuphine. |
| first_indexed | 2024-12-10T21:23:32Z |
| format | Article |
| id | doaj.art-fb99bc6c9822467caa94c43bb1688130 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-10T21:23:32Z |
| publishDate | 2017-07-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-fb99bc6c9822467caa94c43bb16881302022-12-22T01:33:03ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2017-07-01117UC25UC2810.7860/JCDR/2017/24385.10224A Comparative Study of Analgesic Effect of Intrathecal Nalbuphine and Fentanyl as Adjuvant in Lower Limb Orthopaedic SurgeryShagufta Naaz0Usha Shukla1Swati Srivastava2Erum Ozair3Adil Asghar4Associate Professor, Department of Anaesthesiology, UPUMS, Etawah, Uttar Pradesh, India.Professor, Department Anaesthesiology, UPUMS, Etawah, Uttar Pradesh, India.Assistant Professor, Department of Anaesthesiology, UPUMS, Etawah, Uttar Pradesh, India.Senior Resident, Department of Anaesthesiology, JNMC, AMU, Aligarh, Uttar Pradesh, India.Assistant Professor, Department of Anatomy, UPUMS, Etawah, Uttar Pradesh, India.Introduction: Intrathecal opioids when added to local anaesthetics decrease their dosage and provide haemodynamic stability. Nalbuphine is an agonist-antagonist and acts on kappa receptors providing analgesia. Aim: The study aims to compare the analgesic efficacy of fentanyl with that of two doses of nalbuphine when used with injection bupivacaine heavy in spinal anaesthesia. Materials and Methods: A randomised, double blinded, prospective study on 90 patients of ASA I and II undergoing lower limb orthopaedic surgery under subarachnoid block was done. Patients were randomly allocated into three groups (n=30). Each group received 12.5 mg of 0.5% of injection bupivacaine heavy along with either 25 µg of 0.5 ml fentanyl (Group F) or 0.8 mg of 0.5 ml nalbuphine (Group NL) or 1.6 mg of 0.5 ml nalbuphine (Group NH). Characteristics of sensory and motor blocks, haemodynamic changes, duration and quality of analgesia, adverse effects, sedation, VRS score and analgesic requirement were studied at different time interval intraoperatively and till 24 hours of block. Results: The duration of analgesia (in minute) was 441±119.69 in NL Group, 450±103.38 in NH Group and 300.0±88.53 in Group F (p=0.05). There was no significant difference regarding block characteristics and haemodynamic parameters. Total 24 hours analgesic requirement was titrated by analgesic score which was 2.25±0.7 (NH Group), 1.875±0.83 (NL Group) and 3.375±1.77 (F Group) p=0.0186 by ANOVA. The adverse effects of NL Group were least. Conclusion: There was no significant advantage of intrathecal fentanyl or 1.6 mg nalbuphine over low dose 0.8 mg nalbuphine.https://jcdr.net/articles/PDF/10224/24385_CE[Ra]_F(Sh)_PF1(SS_VT_NE)_PFA(NE_SS).pdfhaemodynamicskappa receptorsopioids |
| spellingShingle | Shagufta Naaz Usha Shukla Swati Srivastava Erum Ozair Adil Asghar A Comparative Study of Analgesic Effect of Intrathecal Nalbuphine and Fentanyl as Adjuvant in Lower Limb Orthopaedic Surgery Journal of Clinical and Diagnostic Research haemodynamics kappa receptors opioids |
| title | A Comparative Study of Analgesic Effect of Intrathecal Nalbuphine and Fentanyl as Adjuvant in Lower Limb Orthopaedic Surgery |
| title_full | A Comparative Study of Analgesic Effect of Intrathecal Nalbuphine and Fentanyl as Adjuvant in Lower Limb Orthopaedic Surgery |
| title_fullStr | A Comparative Study of Analgesic Effect of Intrathecal Nalbuphine and Fentanyl as Adjuvant in Lower Limb Orthopaedic Surgery |
| title_full_unstemmed | A Comparative Study of Analgesic Effect of Intrathecal Nalbuphine and Fentanyl as Adjuvant in Lower Limb Orthopaedic Surgery |
| title_short | A Comparative Study of Analgesic Effect of Intrathecal Nalbuphine and Fentanyl as Adjuvant in Lower Limb Orthopaedic Surgery |
| title_sort | comparative study of analgesic effect of intrathecal nalbuphine and fentanyl as adjuvant in lower limb orthopaedic surgery |
| topic | haemodynamics kappa receptors opioids |
| url | https://jcdr.net/articles/PDF/10224/24385_CE[Ra]_F(Sh)_PF1(SS_VT_NE)_PFA(NE_SS).pdf |
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