Original Research Article To compare effect of Fentanyl and Nalbuphine as adjuvant to Bupivacaine in below umbilical surgeries in spinal anaesthesia: A randomised control trial

Abstract

BACKGROUND- In spinal anaesthesia, opioids have been preferred as adjuvants to local
anaesthetics. An effective adjuvant to local anaesthetics appears to be nalbuphine, a receptor
agonist and antagonist. This study compared the effects of nalbuphine and fentanyl when
administered as an adjuvant to bupivacaine during spinal anaesthesia in below umbilical
surgeries in terms of postoperative analgesia and side effects.
MATERIALS AND METHODS- 100 patients belonging to the American Society of
Anaesthesiologists Physical Status I and II were allocated into two groups of fifty each
according to systematic sampling method, patient was allocated into 2 groups according to
their IPD number in which Group A includes (odd IPD number) and were receiving fentanyl
while Group B includes (even IPD number) and were receiving nalbuphine. Each group was
given drug 0.5% Bupivacaine Heavy 3.5 ml along with adjuvant fentanyl 25 mcg to Group A
and adjuvant nalbuphine 1 mg to Group B. Patients were assessed for hemodynamic changes,
sensory and motor block, early postoperative analgesia, and adverse effects.
RESULTS- There are no significant differences in PR, SBP, DBP, MAP and SpO2 of
Fentanyl and Nalbuphine groups. Post SAB motor recovery shows no significant difference
in both the groups using modified bromage scale. It was found that no significant difference
was noted in adverse effect in both the groups. Both intrathecal nalbuphine and fentanyl are
found to be effective adjuvants to bupivacaine in subarachnoid block. However, Nalbuphine
has the longer duration of sensory recovery as compared to fentanyl.
CONCLUSION- Nalbuphine has the longer duration of sensory recovery as compared to
fentanyl.