Comparative study on regression time of block and adverse effects of nalbuphine and fentanyl as an adjuvant to intrathecal bupivacaine: a prospective randomized double-blind study

Abstract

Abstract Background The study was done to observe the effectiveness of nalbuphine as an adjuvant to intrathecal bupivacaine heavy, and hence, it was compared in terms of regression time of sensory and motor block and adverse effects with that of fentanyl as an adjuvant. The study design was a prospective randomized double-blind study. Total number of patients were 100. They were randomly allocated into two groups. Group N (n = 50) received 3.2 ml of 0.5% heavy bupivacaine and 0.5 ml (0.8 mg) of nalbuphine, a total of 3.7 ml. Group F (n = 50) received 3.2 ml of 0.5% heavy bupivacaine and 0.5 ml (25 µg) of fentanyl, a total of 3.7 ml. Assessment of sensory and motor blockade and analgesia was done by visual analogue scale and modified Bromage scale. Results On comparing the spinal block characteristics among two groups to reach, Bromage-3 motor block was found to be significantly shorter in group F (p = 0.03777). The regression time of both sensory and motor block was significantly prolonged in group N (P < 0.0001). No patients required additional analgesic intraoperatively, and intraoperative VAS scores and adverse effects were comparable in the two groups. Conclusions On comparing nalbuphine 0.8 mg and fentanyl 25 µg as an adjuvant to intrathecal bupivacaine, it has been observed that nalbuphine significantly prolongs regression time of sensory and motor block indicating the effectiveness of nalbuphine as an alternative to fentanyl and for prolong surgeries. The incidence of adverse effects was similar in both groups.

Keywords

• Nalbuphine
• Fentanyl
• Hyperbaric bupivacaine
• Nalbuphine prolongs block