A randomized, double blind, control study of the effects of adding nalbuphine to spinal bupivacaine for lower abdominal surgeries in elderly patients

Abstract

Background and objectives: The purpose of this study was to evaluate the onset, quality and duration of sensory and
motor blockade achieved with hyperbaric bupivacaine and nalbuphine combination when administered intrathecally for
spinal anesthesia in lower abdominal surgery as well as efficacy of nalbuphine for postoperative analgesia and its side
effects if any.
Method: 40 ASA I and II patients of age group 50-70 years, scheduled for below umbilicus surgeries were chosen for
this study. Patients were randomised in two equal groups of 20 each by lottery method. Group I (Study Group) received
3 ml of hyperbaric bupivacaine 0.5 % + 0.5 ml inj. nalbuphine (0.5 mg) intrathecally. Group II (Control Group) received
3 ml of hyperbaric bupivacaine 0.5 % + 0.5 ml of inj. normal saline intrathecally. Assessment of motor and sensory
blockade was done by Bromage scale and pin prick method. Pulse rate, BP, respiratory rate and SpO2 were monitored.
Results: There is no significant difference between 2 groups for onset of motor and sensory blockade but mean time of
postoperative analgesia in Study Group was highly significant than Control Group. No patient in our study developed
any side effects.
Conclusion: Nalbuphine provides better quality of block as compared to bupivacaine alone. It also prolongs
postoperative analgesia when used as adjuvant to spinal bupivacaine in elderly patients