An Observational Study to Compare the Efficacy of Intrathecal Fentanyl and Nalbuphine with Bupivacaine in Spinal Anaesthesia

Abstract

AIMS AND OBJECTIVES: Various adjuvants have been used with local anesthetics in spinal anesthesia to avoid intraoperative visceral and somatic pain and to provide prolonged post operative analgesia.The aim of this study was to evaluate the onset and duration of sensory and motor block, hemodynamic effect,postoperative analgesia and adverse effects of fentanyl or nalbuphine with 0.5% Bupivacaine in spinal anesthesia. MATERIAL AND METHODS: Sixty patients classified in ASA I & II were scheduled for inguinal and lower limb surgeries.Patients were randomly allocated to receive either Bupivacaine (0.5%)2.5 ml plus Nalbuphine 1 mg (0.1 ml) + 0.4 ml NS(group N,n=30) or Bupivacaine(0.5%) 2.5 ml plus Fentanyl 25 μg(0.5 ml)(group F,n=30) intrathecal.Time to reach sensory blockade to T10 segment, the degree of motor block,side effects and the perioperative analgesic requirements were assessed. OBSERVATION AND RESULTS: Comparatively fentanyl group showed rapid onset of complete motor block otherwise statistically no significant difference was seen in hemodynamic parameters, duration of motor block and adverse effects. Duration of post operative analgesia was prolonged in nalbuphine group but statistically insignificant. CONCLUSION: Patients in fentanyl group showed significantly faster onset than nalbuphine group otherwise no significant difference was seen hemodynamically and in duration of motor effect. Duration of sensory effect was longer in nalbuphine group but statistically insignificant.