A COMPARATIVE STUDY OF EFFECTS ON SUBARACHNOID BLOCK USING BUPIVACAINE WITH NALBUPHINE HYDROCHLORIDE AND BUPIVACAINE WITH FENTANYL FOR LOWER ABDOMINAL & LOWER LIMB SURGERIES
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Keywords
Intrathecal anesthesia, Nalbuphine, Fentanyl, Bupivacaine, Spinal block, Postoperative analgesia, Hemodynamic stability
Abstract
Background: Intrathecal adjuvants are commonly used to enhance the efficacy and duration of spinal anesthesia. Nalbuphine and fentanyl, when added to bupivacaine, offer distinct pharmacological profiles influencing onset, duration, and side effects.
Objective: To compare the effects of intrathecal bupivacaine with nalbuphine hydrochloride versus bupivacaine with fentanyl in patients undergoing lower abdominal and lower limb surgeries.
Methods: A prospective, randomized study was conducted on 100 patients allocated into two groups: Group N (bupivacaine + nalbuphine) and Group F (bupivacaine + fentanyl). Onset and duration of sensory and motor block, hemodynamic changes, duration of analgesia, and adverse effects were recorded and statistically analyzed.
Results: Group F showed a significantly faster onset of sensory (1.63 ± 0.69 min) and motor block (2.54 ± 0.58 min), whereas Group N had a significantly longer duration of analgesia (321.20 ± 48.66 min) and sensory block (248.68 ± 50.23 min). Adverse effects were fewer in the nalbuphine group. Hemodynamic parameters remained stable in both groups, with better systolic control in Group N.
Conclusion: While fentanyl ensures faster onset, nalbuphine provides prolonged analgesia with fewer side effects, making it a suitable intrathecal adjuvant for extended postoperative pain control.
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Dr Surabhi Talwar
Senior Resident, Department of Anaesthesia and Critical Care, Northern Railway central hospital, New Delhi
Dr Rachit Arora
Senior resident, Department of Surgery, Northern Railway Central Hospital, Delhi