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Indian Journal of Anesthesia and Analgesia

Volume  4, Issue 3, Jul-Sep 2017, Pages 851-856
 

Original Article

Intrathecal Nalbuphine versus Intrathecal Dexmedetomidine for Postoperative Analgesia of Lower Abdominal and Lower Limb Surgeries

Manisha Kanagarajan1, J. Gomathy2

1Associate Professor, Dept of Anesthesia, ACS Medical College and Hospital, Velappanchavadi, Chennai, Tamil Nadu 600077, India. 2Physician Assistant, Madras Medical Mission, Chennai, Tamil Nadu 600037, India.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.50

Abstract

Introduction: Opioids are used as adjuncts with the local anaesthetic for longer duration of action and better postoperative analgesia [4]. Nalbuphine, is a mixed agonist-antagoniste and its analgesic potency is equal to morphine and less side effects like respiratory depression, urinary retention and pruritus. Intrathecaldexmedetomidine increased the duration of analgesia. Aim: To compare the duration of postoperative analgesia and the incidence of side effects of intrathecalnalbuphine and intrathecaldexmedetomidine for lower abdominal and lower limb surgeries. Materials& Methods: 60 patients of ASA I & II, underwent lower abdominal and lower limb surgeries using spinal blockade included. Group I (n=30) patients received Inj. Bupivacaine heavy 15 mg with Inj. Nalbuphine 0.8 mg. Group II (n=30) patients received spinal anaesthesia with Inj. Bupivacaine heavy 15 mg & Inj. Dexmedetomidine (5 mics) Results: The mean onset of sensory block (3.5±0.7 Vs 4.2±0.8) and motor block (1.7±0.7 Vs 2.6±0.9). Both were shorter in nalbuphine group which was statistically significant. The mean duration of analgesia was longer in patients who received dexmetomidine (197±6 min Vs 99.6±6 min), Incidence of hypotension and bradycardia were higher in dexmetomidine group but amenable to medical management. Conclusion: Intrathecalnalbuphine (0.8mg) decreases the mean duration of onset of both sensory and motor block. Intrathecaldexmedetomidine prolongs the duration of analgesia but the incidence of bradycardia and hypotension are higher.


Keywords : Spinal Anaesthesia; Nalbuphine; Dexmedetomidine; Lower Abdominal; Lower Lomb Surgeries 
Corresponding Author : Manisha Kanagarajan, 10/2, Shrestha Retreat, Sathyamurthy Nagar Post, Thirumallaivoyal, Chennai – 600062, Tamil Nadu, India.