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Indian Journal of Anesthesia and Analgesia

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A Critical Evaluation of an Effect of Nalbuphine as an Adjuvant to Bupivacaine for Ultrasound Guided Interscalene Brachial Plexus Block

Prasath Chandran, Associate Professor, Department of Anesthesiology, MelmaruvathurAdhiparasakthi Institute of Medical sciences and Research, Melmaruvathur, Kancheepuram District, Tamilnadu 603319, India. , Anbu Muruga Raj Annamalai1 , Prasath Chandran2

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Indian Journal of Anesthesia and Analgesia 5(6):p 993-997, June 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5618.18

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Abstract

Context: The use of Brachial plexus block under Ultrasound guidance for Anesthesia has increased recently. Various adjuvants are added to enhance the analgesic effect of local anesthetic agents namely opioids, alpha 2 agonist,  dexamethasone, etc.

Aim: The aim of this study was to evaluate the effect of analgesic efficacy of nalbuphine as an adjuvant to 0.5% bupivacaine for interscalene brachial plexus block.

Settings and Design: This is a prospective randomized double blind control study conducted in Melmaruvathur Adhiparasakthi Institute of Medical Science & Research over a period of one year from June 2016 to June 2017.

Methods and  Material: Sixty patients of ASA I and II undergoing elective  shoulder surgery under Ultrasound guided Interscalene brachial plexus block were randomly allocated into two groups of thirty patients each to receive either 20mL of 0.5% bupivacaine with 1 mL normal saline ( Group I-Bupivacaine with control group) or 20mL of 0.5% bupivacaine with 1 mL of Nalbuphine 10mg (Group II- Bupivacaine with Nalbuphine). Onset and duration of sensory and motor block and duration of postoperative analgesia were observed.

Statistical analysis used: Statistical analysis was performed using appropriate test with Graphic prism 5.0 software.

Results: Addition of Nalbuphine with bupivacaine has faster onset of sensory and motor block and enhanced duration of sensory motor block compared to  bupivacaine alone with statistically significant difference (p<0.0001). Nalbuphine prolongs the duration of analgesia significantly (p<0.0001). None of the patients experienced any adverse hemodynamic changes and complications.

Conclusion: The present study explains that Nalbuphine 10 mg added to 0.5% bupivacaine in interscalene brachial plexus
block has significant increase in the duration of analgesia with no adverse effects.

 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5618.18

Keywords

Nalbuphine; Bupivacaine; Interscalene Brachial Plexus Block.

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