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

Manisha Kanagarajan, 10/2, Shrestha Retreat, Sathyamurthy Nagar Post, Thirumallaivoyal, Chennai – 600062, Tamil Nadu, India. , Manisha Kanagarajan1 , J. Gomathy2

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Indian Journal of Anesthesia and Analgesia 4(3):p 851-856, July - September 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.50

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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.

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

Keywords

Spinal Anaesthesia; Nalbuphine; Dexmedetomidine; Lower Abdominal; Lower Lomb Surgeries 

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