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Indian Journal of Anesthesia and Analgesia

Volume  7, Issue 1, January-February 2020, Pages 347-353
 

Original Article

Comparative Study of Nalbuphine and Fentanyl for Total Intravenous Anaesthesia in Short Surgical Procedures

Smita Joshi1, Rosly R Jacob2

1Professor and Head 2Third Year Junior Resident, Department of Anaesthesiology, Dr. D.Y. Patil Medical College, Hospital & Research Centre, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra 411018, India.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7120.47

Abstract

Background: Total Intravenous Anesthesia (TIVA) can be defined as a technique of general anesthesia using a combination of agents given solely by the intravenous route and in the absence of all inhalational agents including nitrous oxide (Gas Anesthesia). Total intravenous anesthesia, based on the administration of Propofol combined with an opioid, has become a popular anesthetic technique. This study is to compare the analgesic effects of nalbuphine with fentanyl as well as associated side effects as adjuncts in TIVA along with propofol. Aim: To study the effect of nalbuphine and fentanyl when used as analgesic in total intravenous anesthesia along with propofol. Methods: This study was conducted on 60 adult patients belonging to American association of anesthesiologists (ASA) Grade I/II and posted for short minor surgical and gynecological procedures. They were divided into two equal groups of 30 each, using statistical table of random number: Group N: Preinduction medication with Inj. Nalbuphine 0.05 mg/kg; Group F: Preinduction medication with Inj. Fentanyl 1 mcg/kg. HR, BP, SPO2, just before induction, immediately after induction and then at every 5 minute-intervals till 2 hours were recorded. Additionally, VAS scoring, Modified Aldrete scoring, Time for rescue analgesia, Respiratory rate were noted after 30 minutes. Results: Hemodynamic parameters like heart rate, systolic blood pressure, mean arterial pressure were controlled better in the fentanyl group at 5 min, 10 min, 15 min intraoperatively. Postoperative analgesia was better with nalbuphine group with reduced visual analogue scale with reduced respiratory depression. Conclusions: Fentanyl provided better intraoperative hemodynamic stability whereas, nalbuphine provided better postoperative analgesia with lesser respiratory depression.


Keywords : Total Intravenous Anesthesia (TIVA); Nalbuphine; Fentanyl.
Corresponding Author : Rosly R Jacob