Efficacy of Intrathecal Nalbuphine Over Fentanyl as Adjuvant with Ropivacaine in Lower Abdominal and Lower Limb Surgeries

Abstract

Background: Ropivacaine also showed the advantage of lesser motor blockade making it preferable when early mobilization is suggested. This helps to hasten the postoperative recovery [3]. Since its introduction into market in 1996, Ropivacaine has been put to extensive use in epidural, intrathecal and peripheral nerve blocks. Objectives: To measure, compare and analyse the below mentioned parameters at regular intervals among subjects undergoing lower abdominal and lower limb surgeries. Material & Methods: A prospective, randomized, comparative study. The study was conducted in the Department of Anesthesiology, Malla Reddy Institute of Medical Sciences a tertiary care centre in Hyderabad. All the patients who were undergoing the elective lower abdominal and limb surgeries in the department of anesthesiology during the study period. Study consisted of 60 cases. Simple random method. All the patients meeting the inclusion criteria were taken into the study. A pre- designed, pre-tested, semi structured and pre-coded proforma was used for recording all the findings. After obtaining Ethical clearance from the Institutional Ethical Committee, study was conducted. Results: Comparison of the Modified Ramsay Sedation Score between the two groups shows that Modified Ramsay Sedation Score at 30, 120, 150 and 180 mins is higher in GROUP-N and is statistically not significant with a p value of > 0.05. Comparison of the Modified Ramsay Sedation Score between the two groups shows that Modified Ramsay Sedation Score at 60 and 90 mins is higher in GROUP-N and is statistically significant with a p value of < 0.001. Conclusion: To conclude, Nalbuphine (500μg) seems to be an attractive alternative to 25μg Fentanyl as an adjuvant to spinal ropivacine in surgical procedures as it provides good quality of intraoperative analgesia, hemodynamically stable conditions, and excellent quality of postoperative analgesia as per our study.