Abstract

Introduction: Opioids as adjuvant to local anesthetics used intrathecally provides very good analgesia. Explanation behind this combination is that these two drugs act at different sites and provide better analgesia.

Aim & Objective: To evaluate the efficacy of nalbuphine as adjuvant to intrathecal bupivacaine on onset, duration of sensory & motor blockade and its side effects.

Materials & Methods: The study was a prospective randomized controlled study, done in Katihar Medical College for a period of 1 year after approval from Institutional ethical committee. Sample size of the study was 60. Patients were divided into two groups (A and B). Both the study and control groups were comparable in demographic parameters like age, weight and height. Group A (n=30) received 3ml (15mg) 0.5% Hyperbaric bupivacaine + 0.5mg (0.5ml) nalbuphine. Group B (n=30) received 3ml (15mg) 0.5% Hyperbaric Bupivacaine+ 0.5 ml normal saline.

Results: The mean onset time of sensory block (T10) in the nalbuphine group was found to be 1.93±0.45 mins whereas in the control group it was found to be 3.30±0.54 mins. The mean onset time of motor block was found to be 2.97±0.56 mins in the nalbuphine group whereas in the control group it was found to be 4.50±0.63mins. The statistical analysis showed significantly faster onset of sensory and motor blockade in nalbuphine group (p value of 0.0001). The meantime of regression of sensory block in the nalbuphine group was 4.65±1.03 hours, whereas in the control group it was 3.21±0.57 hours. Mean duration of motor blockade in the nalbuphine group was 2.87±0.39hours and in the control group was2.05±0.34hours. Statistical analysis was done and p value (0.0002) was found significant.

Conclusion: Nalbuphine added to bupivacaine has an earlier onset of action, prolonged sensory and motor blockade compared to bupivacaine alone. Nalbuphine has lesser side effects as compared to other adjuvants in use now a days.