Comparision of Epidural Nalbuphine/fentanyl as adjuvant to Bupivacaine for postoperative analgesia in infraumbilical surgeries

Abstract

Background: Alleviation of post-operative pain will reduce the surgical stress response and improve outcome of surgery. About 10% of patients undergoing surgeries can develop chronic pain postoperatively. Neuraxial analgesia found to better alternative than other mode of analgesia. This study was designed to compare the effect of Nalbuphine Vs Fentanyl as an adjunct to bupivacaine for post-operative analgesia, haemodynamic variations, side effects after epidural injection on patients undergoing elective lower limb surgeries.Methods: Double blinded comparative study was conducted on 60 patients of ASA I,II category admitted for elective lower abdominal & lower limb surgeries under combined spinal epidural anaesthesia were enrolled for this study. Surgery was done under spinal anaesthesia. At the end of surgery, once sensory regression to T10, post op analgesia was administered via study drug epidurally. Group N patients will be received Nalbuphine 10 mg with Bupivacaine 0.125% diluted to 10ml in Normal saline. Group F patients received Fentanyl 100 mcg with Bupivacaine 0.125% diluted to 10ml in Normal saline.Results: The mean duration of analgesia was longer in Group N (387.83 +/- 38.32 mins) compared to group F (343.60 + /-25.64 min) and was statistically highly significant, ‘p’ value =0.001.Conclusion: Nalbuphine as an epidural adjuvant to bupivacaine provides better postoperative analgesia and very minimal side effects for patients undergoing infraumbilical surgeries.