A Comparative Evaluation of Nalbuphine Addition to Levobupivacaine in Sciatic Nerve Block for Post-Operative Analgesia
Journal Title: International Journal of Contemporary Medical Research - Year 2018, Vol 5, Issue 4
Abstract
Introduction: Pain is a predictable and unavoidable issue in the postoperative Period. Untreated or poorly treated postoperative pain may lead to clinical and psychological changes which enhanced morbidity and mortality as well as the cost and it also impairs the quality of life. Study aimed to evaluate and compare analgesic effect and safety of nalbuphine in addition to levobupivacaine postoperatively in lower limb orthopedic surgeries. Material and Methods: Sixty patients of America Society of Anaesthesiologists physical status I and II scheduled for lower limb orthopaedic surgeries in the Department of Anaesthesiology, Gajra Raja Medical College and JA Group of Hospitals, Gwalior were studied. The patients were divided into Group N (n=30, were given 24ml of 0.25% levobupivacaine hydrochloride + 1 ml(10mg) of nalbuphine) and Group C (n=30, were given 24ml of 0.25% levobupivacaine hydrochloride + 1ml of normal saline). Postoperative analgesia in terms of VAS score, time to first rescue analgesic (duration of analgesia) and side effect or complication were studied in each group. Results: Male preponderance was noted in both group (25 in Group N and 26 in Group C; p=0.749). Mean age of patients in Group N and Group C was 37.90±10.03 and 38.93±12.55 years respectively (p>0.05). Vital parameters like mean pulse rate (min), Blood Pressure in mmHg (systolic and diastolic), and Sp02 (%) were comparable between groups (P>0.05). Mean Arterial Pressure (mmHg) was not significantly high in Group C compared to Group N. VAS score was 38.56±1.79 at 16 hours in Group N, and Group C had 49.46±1.132 at 8 hours (p value < 0.001). At 24 hours VAS score of group N and C were 15.17±1.497 and 15.67±1.714 respectively. Two patients in Group N and one patient in Group C experienced postoperative nausea and vomiting and one patient in each Group C and N experienced shivering postoperatively. Conclusion: Nalbuphine along with Levobupivacaine hydrocholoride is a good alternative for post-operative pain relief as compared to Levobupivacaine alone with minimal postoperative complication.
Authors and Affiliations
Jitendra Agrawal, Ajay Singh, Rakhi Mittal, Bhanu Choudhary
Keywords
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