Efficacy of Intrathecal Nalbuphine as an adjuvant to Levobupivacaine in spinal anesthesia

Balu Srinivasan; Premanath Fakirayya Kotur

Volume : VIII, Issue : IV, April - 2019

Efficacy of Intrathecal Nalbuphine as an adjuvant to Levobupivacaine in spinal anesthesia

Balu Srinivasan, Premanath Fakirayya Kotur

Abstract :

Objective: To elucidate the efficacy of intrathecal nalbuphine as an adjuvant to levobupivacaine for lower abdominal and lower limb surgeries in comparision with control. Materials and methods: A prospective study was done including 80 patients with ASA physical status I and II undergoing lower limb and lower abdominal surgeries under spinal anaesthesia. The study population was divided into two groups of 40 each. Group A patients were administered spinal anesthesia of intrathecal levobupivacine with nalbuphine and Group B patients were administered spinal anesthesia of intrathecal levobupivacine with normal saline. Outcome measures assessed in this study were duration of onset of sensory and motor block, pain score using visual analogue scale (VAS), duration of rescue analgesia and adverse effects. Results: The two groups were comparable in baseline characteristics like age, gender and weight and the duration of surgery of the patients. There was no significant difference between the two groups with regard to sensory and motor block characteristics. The VAS pain score was significantly higher in the group B compared to group A at 12, 16 and 20 hours post operatively (p < 0.05). The mean duration of rescue analgesia required in group A patients was 14.13 � 3.4 hours which was significantly higher than 9.76 � 2.6 hours in group B patients (p < 0.01). The mean total number of analgesic doses required post operatively were significantly higher in group B patients (2.64 � 0.87) compared to 1.45 � 0.59 in group A patients (p < 0.01). Conclusion: The nalbuphine as an adjuvant with levobupivacaine in spinal anesthesia clearly reduces the pain of the patients post operatively, provides increased duration of analgesia and reduces the number of analgesics required.